In this age of information overload and sleek marketing, finding out what cosmetic facial procedure is
right for you can seem like a daunting task. The truth is most people simply don’t know unless they have gone
the costly route of trying any number of different technologies with varying results.
First, one must ask the question, what type of result am I looking to achieve? If subtle enhancement is the
goal, then a non-invasive approach would be appropriate. If significant transformation with elimination of
substantial sagging tissue is your objective, then the skilled hands of an experienced facial plastic surgeon
may be your best option.
In the non-invasive realm, there simply is no comparison to the results achieved through the combination of
Botox Cosmetic, dermal filler and fractional laser technology.
It is natural for most people to feel apprehensive about the idea of having injections or laser devices
applied to their face. However, when in the hands of well-qualified and experienced practitioners who
approach their work with a sense of artistry and pride, there really is little to fear. And the results are
worth it.
Botox Cosmetic injection is a great procedure for reducing that tired and often intense look we get from
forehead and frown lines, not to mention the agedness associated with “crow’s feet.”
Aesthetically, Botox Cosmetic is intended to enhance one’s look, not change it. Only the facial muscles
beneath the lines at the point of injection are relaxed, leaving the other elements of facial expression
active.
Botox has a well-established safety history, having been in use for over 18 years in a wide range of medical
conditions and is one of the most widely researched medicines in the world.
However, patients need to be aware that injecting Botox requires experience, skill and precision. As someone
who injects hundreds of patients each year, I have learned not only “how much and where” but more importantly
“where not” to inject in any given clinical presentation. Botox Cosmetic should only be administered in
an appropriate medical setting by well-trained aesthetic-specialty personnel.
Hyaluronic acid-based, non-permanent dermal fillers such as Teosyal, Juvederm and Restylane work remarkably
well in gently restoring volume loss in the cheeks and mid-face region as well as enhancing the fullness of
lips. I prefer non-permanent dermal fillers as the aging face and personal preferences
are ever-changing and more suitable to “regular fine-tuning” rather than interventions of a
permanent nature.
I do a great deal of combination cheek augmentation plus nasolabial fold (“smile lines” that run from each
side of the nose to the corners of the mouth) reduction using Teosyal Ultra Deep. I find this to be one of my
most personally satisfying procedures. The results are immediate and the rejuvenating effects
dramatic yet natural. People literally look and feel 10 to 15 years younger leaving the office.
Once again, however, as with Botox, and perhaps even more with dermal fillers, the procedure is highly
technique-sensitive.
Sculpting facial contours well requires an exceptional appreciation for subtlety and symmetry. This is
truly an area for those practitioners with a keen eye inspired by a sense of creativity and
artistry.
Finally, non-ablative fractional laser resurfacing devices like the Cynosure Affirm are both safe and highly
effective in improving the overall textural quality of aging and sun-damaged skin. The Affirm reduces pore
size, fine lines and uneven pigmentation, as well as simultaneously tightening the skin. By effectively
stimulating the skin’s own natural collagen production, this remarkable laser is not only a great anti-aging
device but has also helped many of my acne scar patients achieve great improvement with consequent
enhanced self-esteem.
The Affirm is as close to an “all-in-one” complete laser skin rejuvenation system as it gets. The fact is
that the patented “multiplex” dual delivery of fractional resurfacing plus skin tightening in one single
pulse not only enhances the overall result, it also makes for a highly cost-effective treatment for the
patient. One would essentially have to complete a combination Fraxel with Titan treatment protocol at
two to three times the cost in time, money and pain for a comparable result. For this reason, I consider the
Affirm laser a premium device in a class of its own and my patients absolutely love it.
These days the relative affordability of all these technologies when compared to more invasive procedures has
really made facial enhancement attainable for many more people. And why not? When in the right hands, they
produce great results safely, with little or no downtime and certainly need not be feared. •
Dr. Nino Kuzmar is a University of Toronto medical graduate and founding medical director of the St.
Clair Cosmetic and Laser Clinic. He is a cosmetic physician with a special interest in non-surgical facial
rejuvenation.
