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My Face Looks 50, My Hands Look 65

Like the rest of our bodies, our hands show signs of aging that may include brown spots, thinning skin, wrinkles, and large veins. I recently had a very happy facelift patient who looked 15 years younger, but suddenly the skin on her hands didn’t match her rejuvenated face. There a few simple procedures that can make your hands match your new youthful appearance. Plastic surgery on the hands can be rather complicated. However, a few minor non-invasive procedures can be done successfully with impressive results.
Brown spots on the hands can be treated topically with a daily application of hydroquinone cream. In addition, fine wrinkles and pigmentation may benefit from a chemical peel. Light TCA-peels are most effective for eliminating uneven pigmentation in the long term and smoothing the skin. Daily use of a good hand cream containing glycolic acid, Vitamin C, Vitamin E and Beta-carotene is recommended. One of the most effective and convenient procedures is the use of Intense Pulse Light (IPL). This form of photo-rejuvenation will smooth color irregularities and evens skin tone.
With age and sun damage, the skin of the hands may also begin to atrophy, leaving hands with a bony appearance. A procedure known as structural fat grafting can soften wrinkles, cover prominent veins and tendons, and disguise enlarged joints on the hands. It restores the soft tissue that is lost with age or disease, and helps fill out grooves between the bones of the hand, as well as help improve the color and texture of the skin.
Structural fat grafting involves removing fat cells from other areas of the body such as the abdomen, back, buttocks, or flanks, purifying them and then transplanting them into the back of the hand through a series of strategically placed injections. When grafted successfully, these fat cells will continue to live there permanently with lasting results.
Dermal fillers are an alternative to fat grafts for adding volume to the back of the hand. These products are commonly used in other parts of the body, especially the face, and can be employed with minimal discomfort and virtually no down time.
To help minimize swelling, the hands are elevated and cold compresses are applied for 48 hours. Under normal conditions, regular activity can be resumed almost immediately thereafter.
During your consultation, ask specific, detailed questions, view several before/after photos of the surgeon’s work, and obtain several referrals from past patients to inquire about their experiences. Good doctors will be happy to provide you with this information.

This information is brought to you courstesy of Dr. Mark Bishara and The Paragon Plastic Surgery & Med Spa


 

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Minimally Invasive Facial Rejuvenation- by Dr. Mark Bishara, MD

Aside from being the largest organ of the human body, skin is also the only organ continually exposed to the surrounding world, interacting with the environment and reflecting the general health condition and age changes.
How Skin Ages
Understanding the mechanisms by which the skin ages has been increasing significantly, along with considerable progress on the way to prevent and reverse the visible signs of aging. However, there are still several mysterious factors concerning aging process and why we all appear to age differently. Aging of the skin is likely caused by both intrinsic (biologic) ‘intrinsic aging’, and extrinsic aging (environmental) factors ‘extrinsic or photoaging‘; these factors are interconnected and may share a final common pathway. The quality of skin features is greatly affected by aging, as skin ages, it tends to become roughened, lax and wrinkled with some pigmentary changes.
The main feature of photodamaged skin is solar elastosis; with accumulation of elastotic material in the dermis. Meanwhile, photoaged skin shows gradual decrease in collagen content. Additionally, collagen becomes disordered with decreased synthesis and enhanced breakdown. These changes contribute to the skin laxity and wrinkling formation.
Skin Rejuvenation
Besides being an art, facial rejuvenation is a developing science. Patients now routinely present to their physician requesting information on improving the signs of facial aging; it is the physician’s responsibility to select the most appropriate intervention(s) based on the patient’s age, physical needs and concerns, extent and location of volume loss and cosmetic goals. Different therapeutic approaches were used throughout the years to give the face a youthful appearance. However, because each person is unique, there is no one modality that is best for everyone. Therefore, to choose the most appropriate therapy, distinctions must be done between rhytides caused by loss of collagen within the dermis, wrinkles due to volumetric loss of fat, redundant folds created by gravitational pull and those caused by hyperfunctional facial muscles.
For ease of patient education, the treatment options for addressing these changes may be simplified into five categories, often referred to as the ‘5 Rs (Redraping, Resurfacing, Retaining, Relaxing and Refilling) of skin rejuvenation: surgically Redraping and lifting redundant tissue; Resurfacing photoaged skin with ablative or non-ablative technologies whether physical, chemical or mechanical; Retaining with skin care; Relaxing dynamic rhytides that are due to hyperfunctional muscles with neurotoxins and Refilling of diminished subcutaneous tissue by restoring 3D volume.
Ablative and Non-Ablative Procedures
Although ablative modalities remain the gold principle for photodamaged skin rejuvenation, its use is associated with risk of side effects as well as a prolonged and an unpleasant post-treatment ‘downtime’ and recovery period. Thus, interest in ablative treatment has waned considerably while non-ablative modalities as well as fractional skin rejuvenation have become appealing alternative treatments.
New perspectives in non-ablative skin rejuvenation treatments have been established with the development of new technologies and techniques, which are used to rejuvenate skin with minimal downtime and complications. Many different terms have been used to describe these procedures including: subsurface resurfacing, laser toning and minimally invasive skin rejuvenation. These modalities are designed to produce many cosmetic benefits, including improvement of wrinkles, skin laxity and texture.
Beside lasers and various in-office procedures, many topical skin care agents were used for prophylaxis as sun screens and for rejuvenation such as retinoic acid and different anti-oxidants including vitamins C and E, co-enzyme Q10 and green tea.
Choosing the appropriate treatment modality which will be the key to success in skin rejuvenation depends on careful evaluation and determining the patient’s needs, skin type and condition, to frame a treatment plan. Good candidates for minimally invasivetechniques tend to have minimal facial sagging. Patients should understand that skin texture will improve and fine lines will be softened but not eradicated. Cumulative aesthetic benefits will occur gradually and will be less dramatic than those seen with ablative resurfacing. Patients with Fitzpatrick skin type III or less are generally best candidates for different procedures with minimal risk of complications.
Goals of Minimally Invasive Treatments
The goal of most minimally invasive treatments is to induce selective dermal injury which results in wound repair response; while keeping the overlying epidermis intact. In response to the induced dermal injury, the healing process begins to stimulate the fibroblast with deposition and reorientation of collagen bundles. Such modalities for skin rejuvenation could be classified into two types, the first relates to treatment of ectatic vessels, pigmentation and pilosebaceous changes, while the second refers to dermal remodeling with wrinkle reduction and/or skin tightening.
Dr. Mark Bishara, whith office in Mansfield and Southlake, TX- provides a wide range of cosmetic procedures to help patients look and feel their best. These procedures are designed to improve the appearance of the face and body through minimally invasive techniques that provide highly effective results. Many of these procedures can be combined in order to achieve your desired appearance. All of our procedures are performed using the most advanced, state-of-the-art equipment.
At our office we offer many treatments that are ablative as well as non-ablative.  Our Pragon Med Spa offers many laser services- skin tightening, skin resurfacing, as well as peels and microdermarbrasion.  Our office also offers Botox, Juvederm and Radiesse.  The new Juvederm Voluma XC will be coming soon.  Please call our office for more information at (817) 473-2120.
 

 

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5 Tips For Healthy & Young Looking Skin- from Dr. Mark Bishara, MD

Skin experts say that the best way to keep your skin healthy and looking young is to protect it from the sun and not smoke: and after that, taking care with how you wash, moisturize your skin and shave also help.
According to a British Association of Dermatologists survey carried out last year, many Britons are unaware that sun protection can keep the skin looking younger, believing instead that applying a daily moisturizer, eating a healthy diet, drinking plenty of water and having facial massages will suffice.Not only does exposure to UV increase a person’s risk of skin cancer, it also affects the elastin in the skin, which leads to wrinkles and sun-induced skin ageing such as leatheriness and blotchy pigmentation. Featured below are 5 tips for healthy skin:

Tip #1 for healthy skin: Sun protection

Photograph of lady with sun cream on shoulder in shape of sun
Ensure you protect your skin from the sun to maintain healthy skin

Most of the changes seen in ageing skin are actually “caused by a lifetime of sun exposure”.
To protect yourself from the sun, they advise the following three methods (with maximum protection coming from using all three).

  1. Avoid the sun during high intensity hours: the sun’s rays do the most damage between 10 am and 4 pm, so limit the time you spend outside during this period.
  2. Wear protective clothing: wear long sleeved shirts, long trousers or pants and a hat with a wide brim. Remember that tight woven fabric (eg denim) offers better protection than loosely woven fabrics like knits.
  3. Use sunscreen: go for a broad spectrum sunscreen with an SPF (sun protection factor) higher than 15 and apply generously about 20 minutes before you go out and then every two hours. You will need to apply more frequently if you go in the water or sweat a lot.

Tip #2 for healthy skin: Don’t smoke (and watch the alcohol)

Research shows that smoking alone ages skin. In a study published in the Archives of Dermatology, researchers described how they examined the upper inner arms of smokers and non-smokers aged from 22 to 91 and found that after taking into account age and other variables, the number of packs of cigarettes that the smokers smoked per day was significantly linked to skin ageing. They looked at the skin on the upper inner arms to minimize the influence of sun exposure.
Smoking reduces the skin’s natural elasticity by promoting the breakdown of collagen and also reducing the amount that is produced.
Collagen, a protein that helps skin strength, gradually degrades with age, leading to wrinkles. Smoking causes this to happen sooner and also causes the tiny blood vessels in the skin to tighten, which reduces the amount of oxygen and nutrients that the skin cells receive, which also reduces elasticity and accelerates ageing.
The Mayo Clinic also suggest that exposure to heat from burning cigarettes damages facial skin and that certain smoking behaviours contribute to wrinkles, because of the repetitive facial expressions that smokers make, such as pursing the lips on inhaling and squinting their eyes to keep the smoke out.
Drinking alcohol can make your body and skin dehydrated, leaving the skin looking old and tired. So if you are drinking alcohol drink plenty of water and stick to sensible amounts. Have a non-alcoholic drink like soda water or watery fruit juice in between the alcoholic ones to help your body rehydrate.

Tip #3 for healthy skin: Clean your skin regularly and apply moisturizer

A British Skin Foundation survey published in January 2008 found that an astonishing 50 per cent of people who wear make up in the UK are damaging their skin by not removing make up before they go to bed.
The reasons for not cleansing the skin of make up before going to bed were also revealing in that most people were too tired to take it off, suggesting they were not getting good quality sleep which also affects skin health. A significant proportion also said they had had too much to drink or simply couldn’t be bothered.
Cleansing is an important part of skin care because it removes dirt and bacteria; and the key is to do it gently.
Use warm rather than hot water and limit the time you spend in the bath or shower to 15 minutes or less as too much time in hot water strips oils from your skin.

Face being moisturized
Moisturizing protects the skin from drying and acts as a protective layer for the skin

Also, use mild rather than strong soaps and avoid irritating additives such as perfumes and dyes, especially if you have sensitive skin.
When removing make up take care with the delicate skin around the eyes, and if you use waterproof make up you may need an oil-based product to make sure you get it all off.
When you have finished try to pat your skin dry so some moisture stays on it.
Moisturizing is important because it protects the skin from the weather and from drying up and looking dull. It helps your skin maintain its natural moisture levels too, say the Mayo Clinic experts, because it seals in the water already in the skin or slowly release water into the skin.
If you have dry skin avoid alcohol-based products and if you have oily skin avoid oil-based products (use water-based instead).
Some people with oily skin don’t need moisturizer: if your skin feels tight 20 minutes after bathing, then you probably do.

Tip #4 for healthy skin: Get enough quality sleep

Woman sleeping
Focus on quality sleep to keep your skin looking young and healthy

Sleep is essential for healthy skin. Not enough quality sleep will make your skin look tired and older, especially with bags under your eyes. Poor quality sleep can become a vicious cycle because lack of sleep makes you irritable, anxious and depressed, and that makes it harder to get good sleep.
Make sure you have plenty of physical exercise as this reduces stress and creates a healthy tiredness that helps sleep. Yoga and swimming are also good ways to improve sleep.
Aerobic exercise increases the oxygen circulating in your body which helps the skin stay vibrant and healthy.

Tip #5 for healthy skin: Shave with care

People shave to make their skin smooth and hairless, but this can irritate the skin, especially if it is thin, dry and sensitive.
For a smooth shave the Mayo Clinic experts advise that you shave after a warm bath or shower (or press a warm wet cloth on your skin) to soften the hair, don’t shave dry skin, use a clean, sharp razor, and shave in the direction of hair growth.
Make sure you rinse well afterwards with warm water to remove soap and dead cells.
If your skin is irritated after shaving don’t use an alcohol based lotion even if it feels cool, it will make the irritation worse because it dries the skin out.
Dr. Mark Bishara and The Paragon Plastis Surgery & Med Spa in Mansfield and Southlake, TX offers minimally invasive procedures, and skin care treatments to help keep your skin looking great. These treatments are designed to provide subtle enhancements that can improve your targeted problem areas, while allowing you to return to work and your regular activities the very same day. Dr. Bishara is also proud to offer a wide range of enhancing, minimally invasive procedures such as Botox, Xeomin, Juvederm Ultra Plus XC and Radiesse.  Juvederm Voluma XC will be available soon. We will keep you updated or call our office for more information at (817) 473-2120.
 
 
 
 

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Skinceuticals CE Ferulic Made Top 10 List!

Overview of Skinceuticals CE Ferulic

Research and innovation are at the core of the SkinCeuticals company mission, and their dedication to science has established the brand as a leader in the advanced skincare arena.  At the office of Dr. Mark Bishara and The Paragon Med Spa- we offer an extensive line of the Skinceuticals skincare line.  Here is one that just made a top 10 list for great skin care.
Skinceuticals CE Ferulic is a revolutionary antioxidant combination that delivers advanced protection against photoaging by neutralizing free radicals, boosting collagen synthesis, and providing unmatched antioxidant protection. More protection means more youthful looking skin and better defense against environmental aging.
How it works:
C E Ferulic contains ferulic acid, a new antioxidant that doubles the synergistic benefits of C E – neutralizing free radicals,building collagen, and providing improved antioxidant protection. No other antioxidant technology has been shown to deliver comparable levels of photoprotection.
-Provides advanced environmental protection against UVA, UVB and infrared radiation A.
-Stimulates collagen synthesis to improve signs of aging.
-Increases firmness and replenishes lipids to reduce wrinkles.
-Once absorbed, this serum can’t be washed or rubbed off. It remains effective for a minimum of 72 hours, making it an excellent addition to sunscreen.
Spotlight Ingredients:
L-ascorbic acid: Neutralizes free radicals and promotes collagen synthesis.
Alpha tocopherol (vitamin E): Potent antioxidant which promotes the healing process.
Ferulic acid: This plant-based antioxidant neutralizes free radicals, inhibits UV-induced melanogenesis, and has anti-inflammatory properties.
Pros:

  • Highly effective anti-wrinkle serum
  • Concentrated formula provides quick results

Other Notes:
A huge benefit from using CE Ferulic is its photoprotection benefits. Photoprotection is a measure of a product’s ability to neutralize free radicals and protect against oxidative stress. SkinCeuticals CE Ferulic reduces sunburn cell formation up to 96% in UV irradiated skin. Though the smell of the serum is a bit off-setting, the effectiveness of CE Ferulic is apparent after the first time I used it. Its skin firming abilities are incredible, earning it a #3 spot on the top 10 list.
Please call our office at (817) 473-2120 or visit our website to learn more about us as www.markbisharamd.com.
 

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What Do Antioxidants Have To Do With My Skincare?

What are Free Radicals?
Antioxidants are the only defense you have against free radical damage. What are free radicals? A free radical is a molecule in your body which is missing one electron. In an attempt to regain that lost electron, the molecule steals electrons from other molecules, which causes a ton of problems. These free radicals are so highly reactive and unstable, that they cause immense damage to the cells they come in contact with. Sometimes the damage is so severe, that it can even harm your DNA!
You may be asking yourself: what does this have to do with skincare? Well, everything! The harm caused from free radicals doesn’t just affect you on the inside, it affects your skin as well. If your skin has been in particularly bad shape lately, or you’re noticing wrinkles have been forming easier, you may be exposing yourself to too many free radicals. If that is the case, you should examine your surroundings to determine the sources of the radicals.
Smoking, UV ray exposure, and poor diet are very common free radical producers. As you age, and the ability to produce collagen decreases, free radicals penetrate much further, causing much more damage. They will also speed the decline of collagen in the body, allowing wrinkles, dark-spots, and sagging skin to form much quicker.
Antioxidants & Anti-Aging
Luckily for us, there is a way to prevent free radicals from causing damage in the body. Antioxidants such as vitamin C, vitamin E, Omega-3, and many others have proven to minimize free radical damage by donating a spare electron of theirs to end the harmful electron-seeking chain reaction. Taken orally or absorbed topically, antioxidants are the answer to becoming healthier overall, both inside and out.
With your body becoming healthier, your skin will reflect the newfound protection. In the anti-aging skincare world, antioxidants are no secret. The positive benefits antioxidants produce for the skin have been utilized for generations, however they are now harvested synthetically as well as naturally and are incorporated in many skincare & supplement products.
Look for anti-aging products that feature antioxidants, such as Vitamin E and hyaluronic acid, as well as a range of hydrating & firming agents. Please call our office at (817) 473-2120, to find out how we can help you to maintain a healthy face for years to come.
 

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