Phase I – Skin Regime

Back in 1996 my dermatologists recommended I have laser treatments for the broken capillaries on my cheeks, chin and around the creases of my nose.  I declined.  After some research I felt that the laser technology had a long way to go before I would let someone blast my face.  After attending a conference on various skin treatments last summer,  I decided that I was ready for laser. See my previous blogs about my consultation with a cosmetic dermatologist titled SOMETIMES YOU NEED MORE THAN GUINOT SKINCARE PRODUCTS September 13, 2009 and the skin care conference titled WHAT HAPPENS IN VEGAS DOESN’T STAYS IN VEGAS! August 08, 2009.

Prep

1. Wait till January to begin treatments in order to minimize sun exposure.

2. Do a facial on myself every week.

3. Begin eating a very clean diet 2 weeks before the laser treatment.

4. Incorporate a 2 week herbal body cleanse into my prep.

Phase II – Diet Regime

For years I have followed a macrobiotic diet/lifestyle.  However, in the last 2-3 years I began expanding my diet, and my waistline,  to include foods like white bread and pasta, eggs, feta and goat cheeses and drinking more decaf espresso and wine.  I was also using more oils and spices in my cooking than usual.  Before I knew it, I had gained 13 pounds!

Plan

1. In order to prep my skin for laser and to lose 13 unwanted pounds, it was time for me to get back to a macrobiotic lifestyle, and that meant cutting out the above mentioned “offenders.”

2. I would eat a vegan (no animal products) diet Monday – Thursday, including no decaf espresso or wine.  Friday and Saturday were to be my “fun” days where I eat and drink whatever feels right at the time, and this doesn’t mean I go crazy.  If I choose to have wine I will probably pass on an appetizer or dessert. This is the key to being successful with a lifestyle change.

Phase III – Exercise Regime

For my entire adult life I have always done some form of  workout, but over the last few years I was getting quite board.  In Womens Health Magazine January/February 2010,  I found an awesome 6 week workout called “The Ultimate Fitness Plan 2010.”  I decided to give it a try.  Today I began my 3rd week.  It requires minimal equipment, I can do it at home, and each week is different.  By combining yoga into  my new workout I can maintain flexibility and improve my balance.  I already like what I see!

Routine

1. Strength Training: Monday, Wednesday and Friday.

2. Cardio: 30 minutes – 1 hour daily.

3. Yoga: 3-4 times a week.

I am beginning my second month of  my Regime Change 2010 and loving it!  I had one laser treatment, which went very well.  I will blog about it next time.  My extremely clean organic diet is giving me a lot more energy and radiant skin.  Last week a client told me my eyes looked so clear.  I have to admit, I looked in the mirror after she left and the whites of my eyes are very white. In addition, I have lost 7.5 pounds and many inches.  I truly feel this is my year to reclaim my health and I wish all of you success in 2010!

Many of you are aware that proper nutrition is vital for healthy vibrant skin.  Our body continually produces new skin cells.  We require good quality air, food and water to generate healthy cells.  As I tell the teens, if you nourish yourself with junk you will produce junk.  That being said, let’s move on.

Ancient oriental philosophy draws from the 5 Transformations of Energy for nutritional guidance.  The system consists of 5 energies: Water, Tree, Fire, Soil and Metal. These energies correspond to our 4 seasons.  Our Indian Summer or Early Fall season is represented by Soil energy, which is settling down energy.  Plants are dying back and settling their energy inward for the fall and winter seasons.  During this season our bodies focus on restoring energy to our stomach, spleen and pancreas organs.  There are certain foods we should incorporate into our diet to assist this seasonal process.

Try to incorporate seasonal foods like:

GRAINS: millet, oats, sweet brown rice, sweet corn

VEGETABLES: onions cabbage, Brussels sprouts, squash, turnips, daikon radish, carrots, parsnips

FRUIT: peaches, melons, grapes

Try my Harvest Dinner of Squash-Apple-Curry Soup, Root Vegetable Casserole and Brussels Sprouts with Shallot Vinaigrette. Read on for the recipes, and enjoy!  If you like the recipes please let me know by commenting.  Any questions can be posted in the comments and I will answer in the comment section.

SQUASH-APPLE-CURRY SOUP adapted from Lorna Sass’ Great Vegetarian Cooking Under Pressure.      Like many cooks, I adjusted the recipe to suit my tastes or whatever ingredients are available in my kitchen.   Serves 6 to 8.

Canola oil for sauteing

2 cups chopped yellow onion

3 pounds butternut squash, peeled, seeded and cut into small chunks

3 Granny Smith apples, peeled, seeded and cut into chunks

1/2 cup raw cashews for a rich flavor or 1/3 cup uncooked rolled oats if nut allergies are a concern                  

Grate  organic ginger (you can leave the skin on) till you have a loose pile about the size of a ping pong ball, and squeeze the juice into (about 1 tablespoon) a bowl.  Throw away the pulp.

1-1/2 tablespoons curry powder

1 teaspoon sea salt

4 cups boiling vegetable stock like “No Chicken Broth” or 4 cups boiling water

Chopped parsley or green onions for garnish

Gadgets: pressure cooker or big soup pot, stick blender (a.k.a. hand held blender)

Heat some canola oil in the pressure cooker and saute the onions.  “Sweat” the onions by sprinkling them with sea salt while sauteing.  After the onions are translucent (in a few minutes, don’t burn them), cautiously add 4 cups of boiling stock being careful not to burn yourself, add the squash, apples, cashews, ginger juice, curry powder and 1 tsp sea salt.  Secure the pressure cooker lid and bring up to pressure and cook for 25 minutes. You can allow pressure to release naturally or do a quick release.  Blend all of the ingredients with your stick blender until smooth and creamy.  Garnish with parsley or green onions.

If you don’t have a pressure cooker you can use a covered soup pot and simmer till all of the ingredients are fork tender.  You will want to oatmeal instead of nuts.

ROOT VEGETABLE CASSEROLE Serves 4-6.

1/3 package Mochi*, coarsely grated

1/3 cup soy or tamari sauce

1/3 cup unrefined corn oil

1/2 cup water

2 carrots, 2 parsnips, 2 potatoes, 1 small turnip, 1 small rutabaga, 1 small daikon radish and 2 sweet or yellow onions. Be flexible – you don’t have to use all of these veggies.  If you don’t like some of these, don’t eat them, but if you are unsure – please try them.

*Mochi is punded sweet brown rice which when cooked makes a creamy gravy.  You can buy Mochi in the refridgerator or freezer sections of health food stores.

Directions:

Preheat oven to 400 degrees.  Peel & quarter the onions.  Peel and cut the rest of the veggies into bite-size chunks.  Place all of the veggies in a glass baking dish.  Whisk the soy sauce and corn oil, add grated Mochi, add the water and stir Mochi into liquid.  Pore this over the veggies, cover glass dish with foil and bake for 20 minutes.  Then check to see if the Mochi is melted into a creamy sauce and the veggies are tender.  If not, stir the veggies, cover and put them back in the oven for another 15-20 minutes.  You’ll love this thick, rich, creamy and healthy sauce!

BRUSSELS SPROUTS

6-8 Brussels sprouts per person

1 large shallot finely minced

3 cloves garlic pressed

1/2 cup extra virgin olive oil

1/2 cup white balsamic vinegar

sea salt

Remove the outer leaves of the Brussels Sprouts and cut an X into the bottom of each sprout in order to cook the more dense part.  Boil the sprouts till bright green and fork tender.  Do not over cook.  Rinse with cold water, drain well and put them in a large bowl.

Vinaigrette

In a jar with a lid, pour in the olive oil, white balsamic vinegar and a pinch of sea salt.  Cover and shake.  Saute the shallots in olive oil for a minute, then add the garlic and continue to saute for another 30 seconds.  Mix the shallots and garlic to the vinaigrette and pour over the sprouts.  Bon appetite!

For many people January 1st is when they make their New Year resolutions, but for the rest of us it’s September that triggers all kinds of lists.  We seem to function on the academic year instead of the calendar year.  By the time September rolls around I have been to too many potlucks and cookouts for my own good.  We seem to indulge in numerous outdoor parties because before you know it, it’s too cold to be hanging outside.

Making our lists ~

Every September my clients, friends and myself say we need to be more diligent about exercise, eating well and finishing those outdoor projects that somehow went undone.  Well, I am combining my exercise with cutting and stacking wood for the woodstove, the grill and the fire pit, plus my yard is getting cleaned up at the same time!  I also believe now is the time to cook outside; it’s not too hot to stand over the grill.

Eat well my friends~

So, I encourage you to visit your farmers’ market and enjoy some grilled veggies on brown rice for a simple healthy meal that is also good for your skin.  And this is where I sign off because I need to light the grill to sautee some green onions and mushrooms to put over grilled polenta. In addition I will stuff the roasted red peppers (which I did on the grill last night) with brown rice, pesto, pine nuts and alittle goat cheese. Bon appetit!

1. Broken facial capillaries. I am considered to be the perfect candidate for laser because I have pale skin and light eyes so the physician recommended laser treatments; specifically a non-ablative VPL-V Beam laser and a VPL-Pulse laser.  It was her feeling that we start with the V Beam and if necessary use the Pulse laser for larger more prominent vessels.  It was also her feeling that I would need more than 1 treatment session but no more than 4.  The down time or the time that you would not want to be seen by others is about 4 days.  If the treatment is done correctly, you should not have a “burn,” but you will be quite red and puffy.  You need to wait 6 weeks between sessions.   They say timing is everything, because you should avoid sun and alcoholic beverages before and after the treatments.                                                                                                                                      Cost: V Beam $365.00 per session and Pulse $325.00 per session.
2. Brown spots or hyperpigmentation.  Guinot skincare features a lightening line of serums, creams and masks that fade hyperpigmentation, but it doesn’t always eliminate them.  For this reason I asked the physician about the best method for total elimination of brown spots.  She recommended laser again, saying that certain wavelengths of light will target certain colors, like brown.  Like the capillary treatment, you need 1-4 treatment sessions to totally eliminate brown spots. I have to say the photos of some patients who underwent treatment for this condition were pretty scary, but the healed result was awesome.  It should be noted that results appear gradually over several weeks.                                                                                                                                                                Cost: They didn’t quote me a specific number, but like the above laser treatments, I assume it is in the same cost range.
3. Restylane Injections.  This is a simple procedure that has immediate results and occasionally you may experience bruising.  Approximately 6 weeks after my client (see previous blog What if you could erase away the lines.” Aug 12, 2009) had restylane she looks better and better as time goes by!  My previous blogs discuss this in more detail.  Cost: $550 per 1cc syringe.
4. Sclerotherapy or Spider Veins on the feet and legs. The doc said the best treatment they have is injections of an isotonic solution.  Unfortunately, if they miss or shoot through the vein you can have tissue necrosis (and that means death to the skin) in that spot.  It will eventually heal, but it can be a nasty wound for awhile.  I asked her about laser since I saw that in one of their brochures, but she didn’t like to go that route because you have to use a stronger, deeper laser to target the veins than on the face.  This could cause tissue damage too.  However, she did say if I wanted to try the laser she would use a nonablative YAG laser.  Cost: $375.00 per session.  Because many of my clients have not had any luck with the injections working I asked about the reasons why. The physician said you often need several treatments to get results.  At that point I decided this was not for me and forgot to get the price for injections.

After my appointment I decided I would go for the laser treatments to address my broken facial capillaries.  However, I will wait till after the holiday season to begin a series of treatments.  Because these treatments are cosmetic, insurance companies will not cover the cost of treatments. Darn!

In 3 days I have an appointment with a cosmetic dermatologist to discuss my options for removing the broken capillaries on my cheeks, chin and around my nostrils.  These unfortunately were the aftermath of years of using Retin A and topical steroids.  You can read about my situation on my website at the About Us section.

Categories

If you’re like me, you have a ton of questions for your doctor and find that you forget to ask most of them during your appointment.  That is why I spent about an hour very carefully looking at my skin from head to toe taking an honest assessment and writing my wish list of desired repairs.  I divided my list into categories.  Under each category I listed my problem areas, left room to take notes on the treatment options and have a spot to record the cost of the procedure.

My Specific Categories

1. The repair of broken capillaries on my face.
2. What are the white spots or hypopigmented spots on my arms and legs.
3. Treatment options for the newly surfaced hyperpigmentation spots on my jaw and temple area.
4. Dermal fillers for the laugh lines or nasolabial folds, oral commissures and marionette lines.
5. Spider veins around my ankles.

Whew!  It is quite a list and I’ll give you the full details of my visit on my next blog.  Until then eat healthy and exercise in order to achieve perfectly balanced skin!

Three weeks ago a client, we’ll call her Wendy, asked me to accompany her to an appointment with a cosmetic dermatologist.  Wendy is 51 years old with thin fair skin. For many years she has taken good care of  her skin getting regular facials and using great products like Guinot, but recently she had begun developing lines from the nose to the corners of the mouth, a.k.a. smile lines or nasolabial folds, divits at the corners of the mouth, known as oral commissures, and from the mouth down to the jaw, a.k.a. marionette lines.  I asked her what she was having done and she said she was getting Restylane injections in the lines around her mouth.  Wendy said she wanted me, as her aesthetician, to be there as a watch dog since this was her face we were talking about.  She wanted me to keep a close eye on the doctor and to stop her if things weren’t looking right.  I gladly accepted the offer.  As with all cosmetic procedures you want your skin in tip top shape before having any work done, so we did a Guinot Hydradermie facial the day before her injections.

The Big Day

I met Wendy at the cosmetic dermatology clinic at 8:15 a.m. on July 22nd.  She was very nervous and said her stomach was quite upset.  The nurse took us to a treatment room and told us about the various procedures she let the docs practice on her.  I was thinking better to have them practice on the staff than the patient!  I caution all of you thinking about cosmetic procedures to make sure the nurse or doctor does that procedure all of the time.  This is especially true with dermal fillers, like Restylane and Juvaderm, or Botox, because the results are totally dependent upon the placement and amount of drug injected.  Wendy had checked to make sure that her doctor had done this procedure many times over many years.  So we were off to a good start.

The doctor came in, gave Wendy a mirror, and they discussed the areas of concern.  The doctor wanted to go closer to the nose than Wendy thought was necessary, and explained it was so there would be a smooth line all the way from the nose to the corner of the mouth.  We all agreed that the doctor would know best in this situation.  So the first step was to inject lidocaine in to the inside of the upper lip to numb the area.

The doctor made sure Wendy was numb and then she gently pinched the skin to see exactly where the nasolabial folds were before inserting the needle.  After the needle was in, the Restylane was injected while the needle was simultaneously pulled out leaving a line of Restylane under the skin.  It is this technique that is crucial for favorable results!  It only took 2 injections to fill the whole nasolabial fold on one side of the face.  You don’t want a bunch of injection sites with globs of filler at each site, otherwise you’ll get a bumpy line instead of a nice smooth line.

They warn of possible bruising and it isn’t necessarily from the injection, but instead from manual manipulation of the dermal filler.  Immediately after the injection the doctor reached in to the mouth with her fingers and placed the thumb on the outside so as to aggressively massage and pull the filler down the nasolabial line to remove lumps from the pockets of injected Restylane.

After doing the other side of the face Wendy was handed a mirror.  There was some swelling but the results were immediate!  When Wendy asked about the marionette lines the doctor said sometimes less is more.  She was definetly speaking my language.  Then she told Wendy she would rather error on the side of less and to go home and live with it for a few weeks; then if she wanted her to do the other areas she would.  Plus at this point she had used 1cc or one vial worth of Restylane which cost $550.

After Treatment Care

1. Ice for 15 minutes a couple times per hour throughout the day
2. Don’t workout till tomorrow
3. Wait at least 2 weeks before having a facial

So the actual procedure took about 30 minutes and Wendy said it was not painful.  Wendy ended up with a very small bruise which was easily covered with makeup. I was so impressed with this particular physician that I set up a consultation for the end of August to discuss laser treatment for broken capillaries  on my face and legs plus dermal filler injections.  I will be blogging about my consultation in a few weeks.  Meanwhile please note that I post  weekly and would love for you to pass my blog address on to your friends.

]]> http://www.perfectlybalancedskin.com/blog/?feed=rss2&p=40 0 http://www.perfectlybalancedskin.com/blog/?p=27 http://www.perfectlybalancedskin.com/blog/?p=27#comments Sat, 08 Aug 2009 21:06:00 +0000 Margo http://www.perfectlybalancedskin.com/blog/?p=27 This summer I attended the International Skin Care Conference in Las Vegas.  Since many of my clients are having Botox and dermal filler injections, laser resurfacing and plastic surgery, I decided to skip the spa conference lectures and head straight to the Medical Aesthetics Procedures conference.  The speakers were scientists, plastic surgeons and dermatologists. I want to share some of the information I received regarding these procedures, and to make it easy to understand, I am not going to use medical jargon.

Eye, Face & Neck Lifts: These procedures are appropriate when there is a lot of loose skin that cannot be tightened with various types of facials, firming creams or dermal filler injections.  Many people develop sagging upper eyelids that can interfere with their vision.  If this is the case, many insurance companies will cover the cost of the procedure.  If your lids are sagging and you are sick of people asking you if you’re tired or didn’t you sleep well, then you may want to check out this surgery.  It’s a fairly easy surgery that isn’t too painful, the scars are buried in your natural creases and the down time varies depending on the amount of swelling and bruising. Lower lid surgery is for dealing with puffy bags. The incision is done on the inside of the lid so it’s not visible. However, the surgeon may put a stitch or two in the outer corner of the eye to tighten up some wrinkles. The cost is generally $3000 and up.

Face lifts can include the forehead, often known as a brow lift to pick up the eyebrows and upper lids. I personally don’t like the looks of this procedure because these people can look like a deer in the headlights. However, if you have a lot of droop going on a surgeon will recommend this over a blepharoplasty (sorry, medical jargon for eyelid job). Many people think of a face lift as tightening the jowls and raising that frown in to a smile. If you stand in front of the mirror, pull back on the skin and like the look, you are probably a candidate for a face lift. Often, these patients end up having some work done on their neck at the same time. Unlike eyelid surgery, this is some pretty serious stuff. Your outcome can range from absolutely fabulous to disastrous.  You really need to do some research before considering major surgery like this. The cost is generally well over 10 grand.

Lasers: There are many types of lasers such as ablative and non-ablative. Ablative remove live skin cells. This is a very deep and painful procedure that results in weeks of down time. Therefore, many people prefer non-ablative which only take off dead cells. This can also be quite painful depending upon the amount of surface being treated. And then there are many types of non-ablative lasers, but were not going into all of those. Lasers can be used for deeply wrinkled skin. According to the surgeons, lasers work better on deep wrinkles than face lifts, and often they will do both to get the desired results. But in general, lasers are great for removing wrinkles, broken capillaries (and not just on the face, but the legs too), hyperpigmentation and acne scarring, including pitted acne scarring.  I will personally be going for a laser consult this month regarding broken capillaries from my previous dermatoligical issues which you can read about on my web site in the section About Us. I will be able to give you more info, including cost, after my appointment.

Botox Injections: Botox was originally used to give some relief to people who suffered from eye ticks.  Since it paralyzes the muscle it is now being used between the eyebrows to stop brow furrowing, on the forehead to stop creasing and at the outer corners of the eyes to stop crow’s feet from forming. Now here’s where it got interesting at the conference. Some of the doctors believe in injecting Botox around the mouth and another said, “Are you nuts? People, let’s remember the function of Botox, it is a paralytic! Never Never use it below the eyes!” Some said they mixed it with dermal fillers inorder for the fillers to last longer.  It was quite a lively discussion and most of us were laughing so hard we could hardly take notes. I think it’s worth mentioning that if the injection is not placed in just the right area, the side effect can be eyelid drooping.  The effects last 3-6 months. The cost is $500 and up per vial. To do the area between the brows you will only need 1 vial.

Dermal Fillers: These can range from fat to collagen to silicone, but I am going to focus on hyaluronic acid a.k.a. Restylane or Juvaderm. Fillers are used to plump up creases. Common injection sites are between the eyes, smile lines, divits at the corner of the mouth, lines from the mouth down to the chin, the chin and around the mouth. Some doctors like to inject this in the under eye area to lessen dark areas. The thought is that the skin has become thin and sits too close to veins which results in darkness. By filling this area it lifts the skin so it doesn’t look so dark. Hyaluronic acid naturally exits in your body, especially in the skin and it holds 1000 times it weight in water. That’s some pretty amazing stuff. Now here is someting else that’s amazing, when the skin is injected with hyaluronic acid, the fibroblasts (the cells that produce collagen) are stretched and they think they are young again, so they start producing more collagen! That’s why after a few episodes of injections, the results last longer and longer! I like this product because it is naturally found in the body. Because it is bio-identical, I am told that people don’t have adverse reactions.  Minor bruising and minimal swelling is common. The first treatment lasts 3-6 months. The cost is $500 and up per vial. It takes about 1 vial to do the smile lines.

Deciding upon whether or not to undergo a cosmetic procedure is very personal.  Some people care very much about their physical appearance while others don’t.  In writing this blog I don’t want you to get the impression that I am pushing any of the above mentioned procedures.  It’s just that over the last few years numerous clients have asked me about various cosmetic procedures, so I wanted to pass along some info to those who are interested.  If you have any questions, please ask them in the comments, and I will answer back in the comments; or you can e mail me at info@perfectlybalancedskin.com

So that is a brief summary of what I learned in Vegas.  Stay tuned because my next blog will discuss my experience watching one of my clients being injected with Restylane (brand name of hyaluronic acid) a few weeks ago!

So last week my girlfriend and I packed the car full of  fun books, work reading material, laptops, weights, a yoga mat and organic food, and set off across country to a hot, sunny southern destination.  My plan was to do yoga every morning, and lift weights every other day, as I normally do at home, eat a healthy breakfast and take a walk by mid morning each day.  How hard could that be?

Well, after 15 hours in the car, we skipped dinner and sat up till the wee hours drinking champagne and gabbing with my son, whom I hadn’t seen in months.  The next morning we dragged ourselves out of  bed at the crack of 10 am.  I did manage to do yoga and lift weights. By the time I ate it was way too hot to take a walk, and it was practically time for lunch! Oh well I thought, tomorrow I’ll get up early and be on track.

By day 3 I did no yoga or lifting, and had yet to take even 1 walk because we were staying up all night watching movies! Thank goodness for Guinot Eye Mask. I have learned over the years to keep to a tube of eye mask on the beside table, no matter where I am, and slather it on my upper and lower eyelids so it doesn’t look like I’ve stayed up all night working…or watching movies.

I also had failed to get caught up on my reading. Where does the time go?  However, we were socializing with friends everynight, cooking dinner for as many as 10 and generally having a damn good time.

So here it is, my last day of vacation, we’re driving home and I’m writing this blog from the car and trying to get caught up on some of that reading.

Can you stay disciplined on vacation? Obviously I can’t!  Better luck to all of you.

I was listening to a dermatologist, who specializes in sunscreens, speak about various SPF’s and application of product.  He said, regardless of what the SPF is, you really need to re-apply ever 1-2 hours depending upon how easily you burn because all sunscreens begin to break down after one hour.   He also recommends you use about one and one half tablespoons of product for your face and neck.  Dab the product all over your face and neck and then rub in instead of starting with all of the product in your hand and trying to blend it all over.  For the body he recommends at least one ounce or that would be at least one shot glass full of product.  I recommend Guinot Suncare products which you can find on my web site, www.perfectlybalancedskin.com These are some of the most technologically advanced sun products in existence.  I haven’t burned yet while using Guinot suncreens.

Please be serious about protecting your exposed areas.  Many of my clients have developed skin cancer this year due to years of previous sun abuse.  Ah, if we only new then…  Anyway, the skin cancer, melanoma, is the most deadly and the most curable cancer if caught in time.  To be on the safe side, please have a yearly overall body check by a dermatologist.  If you do have skin cancer, especially on your face, neck or chest ask about having Mohs surgery.  This is a microscopic surgical procedure in which biopsies are sent to the lab while the patient waits.  The biopsies are examined  layer by layer to determine how far the cancer has spread.  With this knowledge the surgeon can excise the tissue with smaller margins thus resulting in the least amount of scarring.  They claim the cure rate is 99%!

So for the remainder of the summer don’t forget to slather on the sunscreen while enjoying the outdoors!