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3) What are some skin care No-No’s?

Tanning beds! That’s pure UVA & B that can cause sun damage to your skin and that causes breaking down of the collagen and the elastin. It breaks down the skin and makes it very unhealthy, and it also leads to skin cancer, including basal cell and squamous cell. Alcohol is very dehydrating as well as carbonated drinks. So the best thing that we can do for our skin is drink water. A lot of anti-oxidants that we take in fruits and vegetables are excellent for our skin. Supposedly, Queen Nefertiti used the anti-oxidant rich peel of fruits on her skin.

4) Is some sun really good for you? If so, how much?

Yes, we need a little bit of sun every day in order to have our skin process our vitamins properly. I always tell my kids that in the time it takes to put your sun screen on, you’ve had your dose of sun for the day. Just walking from the house to the car is enough.

5) Do any drug or department store skin care products actually work?

There is a cleanser that is very mild called Cetaphil that is excellent for all skin types. You can also find alphahydroxy or one of the fruity acids like lactic acid or glycolic acid in low percentages (percentages can range from 1% to 30%) in over-the- counter products, and they will help you to a certain level. But when you get to a certain level and you want to take your skin to a new higher level, you’ll need to increase some of your concentrations and use more powerful topicals. When you buy products at a physician’s office, the percentage of the active ingredients is at a higher concentration, so it’s more powerful. The only ones that I carry in my office are ones that I’ve read the research on, and tried myself or my staff has tried; we examine the before and afters and see results. That’s the only way that I can honestly recommend that it works.

But having said that, first of all you need to see a physician who specializes in cosmetic medicine, who can analyze your face and your skin type. Right now we’re just talking about skin care, but often enhancements can go beyond that because we have people who have loss of tissue in certain areas or they have excess sagging.

6) Labels on beauty products are so confusing. How can you know which ingredients work?

There are key ingredients that one must have-for instance-what’s called mechanical sun blockers. Titanium dioxide, and zinc oxide are now micronized, crushed into tiny micronized form, so when you see them in the ingredients, that is good for mechanical skin block. We also have chemical sun blockers, such as Parsal 1789 that are good, so yes, there are certain ingredients that are key.

Still, when it comes to looking at ingredients, it’s not just ingredients- it’s skin types. There’s the red-headed, green eyed, fairer than fair woman and then we have people who have a lot of pigment, such as an African American or an Indian person. So it takes a facial skin analysis by a skin expert who can say, “these ingredients will work well for you.” You have to analyze the product and the person.

7) What do you think about skin analysis at a department store? Lot’s of women do it…

You can’t expect anyone at a drug store counter to really understand conditions such as rosacea, infections and other conditions that can effect skin. Yet, on the other hand we have certain aestheticians who have been in the business and who have learned from physicians or other skin care specialists who are excellent, and I find some aestheticians who are superb in making skin care recommendations. You can always ask for a person’s training and credentials before trusting your face to them, whether at the store counter or the doctor’s office, for that matter.

In our office, you can receive a COMPLIMENTARY SKIN CARE CONSULTATION at no charge whatsoever. There are many physicians and aestheticians who will do this. It’s really important as you walk along that overwhelmingly long counter and you don’t know which product to begin with, to have the knowledge to empower you to know which choice is right. So I really think the first step is to have your own face analyzed.

8) How do you go about choosing the right doctor, both for skin care and for plastic surgery?

Choosing the right doctor is really key! First of all, don’t go to a foot doctor to get a face lift, even though they’re able to do face lifts legally. It’s important to get a doctor who specializes in this and who belongs to certain special organizations such as the American Society of Ophthalmic and Plastic Reconstructive Surgery (known as ASOPERS. Check out their website at www.asopers.org)

It’s important to do your homework. Ask the doctor you are considering to show you before and afters because that’s a telling sign. Ask, “Is this your work, doctor? Are these your patients?” The second thing is you also want to ask questions, “How long have you been doing this and what kind of training do you have?” Also, if your doctor does the same thing every day, they have a comfort zone, and also they’ve seen a lot of complications. The next thing I’d want to know is about their character, “Are you honest? Do you have integrity? Are you persistent? Are you meticulous about details?” That doesn’t take any intelligence, that takes dedication. A duality of requirements, intellectual acumen and personal character.

9) Is it inevitable that your skin will wrinkle and sag?

First of all, we can’t stop time and gravity or the hyper-mobility of certain parts of our face. If you look at my picture from10 years ago, you’re going to see some changes. The journey that I like to help take people on is to have the best face, the best version of themselves that they can be. For example, I have a 50 year old woman patient who says, “I just want to look a good 50, I don’t want to look 20.” So what do we do about that? We look at the cause of the wrinkles. Some of it’s inevitable, but the graceful journey is what we’re all about and that’s what I’m hearing from my patients.

Sagging skin, nothing short of surgery can correct. It’s a tuck and a lift, and all of a sudden we can open up a woman’s eyes with a hidden incision, brow lift and a lid tuck called a blepharoplasty where we hide the incision right in the crease.

When you think about wrinkles and aging, though, you have to look at the cause of the wrinkle, I call them our sinkers, our saggers, and our squeezers. Sinkers describes a loss of tissue, and when we’ve lost tissue, especially in our 40’s, 50’s and 60’s, we’ll notice that we’ll look in the mirror and we look sad sometimes. That’s due to the corners of the mouth pulling down, our lips kind of role inside our mouth as we get older. With subtle enhancements with a dermal injectible like Restilin, it’s basically a natural sugar that you can fill in the creases; it’s like caulking. So you can take the down-turned corner of the mouth and tip it up. A lot f women like that. They like to look in the mirror and see a pleasant expression. The second place you tend to look at someone is the mouth, because it tends to move a lot, especially in my case (she adds laughing). The filler is the other “no down time” category.

Restilin plumps and BOTOX Cosmetic relaxes so the sinking and the squeezing is taken care of. Squeezing describes the “11” those 2 vertical lines on the forehead that tend to show up when the angry muscles of the face are stuck in overdrive. When I use BOTOX Cosmetic, when I try to frown, not a whole lot’s happening; but I can still lift, I can still smile, I’ve got plenty of expression and my eyebrows move fine. It lasts four months. But that’s the beauty of it, because permanent treatments often cause permanent problems while BOTOX Cosmetic has been used in over 75 countries for 20 different medical conditions for 15 years.

The finesse comes in when someone who understands someone’s unique facial anatomy, someone who’s a master aesthetician or someone who’s a master surgeon will use the surgery as a paintbrush and your face as a canvas and create art. So we combine the modalities of surgery and BOTOX Cosmetic and sometimes some filler. You can find a list of well trained serious professionals that have given BOTOX Cosmetic with a certain level of finesse and technique at www.loseyour11.com- and it’s listed by zip codes.

I want people to be able to have that natural look but still have someone looking their best. It changes them but it doesn’t over change them so they look overdone –like a deer in the headlight or the wind tunnel look. This is a message that I’ve been getting from a lot of people-from celebrities to soccer moms. What’s fun for me is to be able to take that age-related issue of facial prejudice and banish it. Gone!

10) What are the best non-surgical techniques?

Sometimes, people want to have a little pick-me-up before holidays, like Valentine’s Day. So a quick Glycolic Peel or a Medical Microdermabrasion, things that will only leave you red for 20 or 30 minutes after the procedure are good. These are wonderful things to help the contour of your skin. BOTOX Cosmetic can be used to release the 11 and to smooth out the brow area and give you a rested countenance. The fillers can be used anywhere there’s a loss of tissue, at the corners of the mouth, on the nose, and in other parts of the face where there’s loss of tissue.

10) Surgical techniques?

Are best left for when you have at least a week’s time for recovery.

11) How much do these procedures cost?

Everyone does not need all those categories that I mentioned. Topicals are fairly affordable-they might cost $30-$60, but they might last six months, so some people might just do topicals. Then, there are others who might want a quicker boost, so they’ll do a chemical peel like Microdermabrasian which is in the $100 range, and Botox will cost an average of $300-500 and it lasts about 4 months. As I mentioned before, a full eye lift can cost anywhere from $1000-5000 depending on the difficulty of the surgery.

Is more expensive better? I can’t help but ask. It depends on which procedure, which product and which physician. I have a patient who told me his Botox cost about the same as his daily Grande Latte, about $5 bucks a day, so it’s affordable. You have to remember that your face is the only outfit you wear every day! I find that cost is not so much a factor as quality, track record, and reputation.

Alas, though I still had lots more questions to ask Dr. Sherman, she had to go. After all, it’s not really that surprising, she had patients waiting. But before she walked out the door, she added, “Women-we need to empower each other, and we need to do more than that.”

And I, of course, couldn’t agree more.

To find out more about Dr. Deborah Sherman, check out www.ShermanAestheticCenter.com For an appointment with Board Certified Dr. Sherman at the Sherman Aesthetic Center, Nashville, TN please call for an appointment at 615 297 5798. Please note that she offers a COMPLIMENTARY SKIN ANALYSIS AND SKIN CONSULTATION for any woman who wants to really know more about how to care for her skin.

For more information about plastic surgery go to www.ASOPRS.org and check out the Patient Information section.

To find an exceptional Botox Cosmetic qualified physician in your area, visit www.loseyour11.com

www.Dishmag.com / Issue 53 - September 5754
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