After listening to Dr Polla’s latest interview on WRS “Protect your skin and is Botox safe?” I realized that nowadays we talk a lot about the potential damages the sun may cause, but not enough about all its virtues. Life on earth depends on its emission of heat and light, and we, human beings, are no exception. I started to look for scientific studies showing the benefits of « intelligent » exposure to UVs. After reading some of the medical reviews piled on my father’s desk, here’s what I learned.

Apart from ensuring healthy bones, the sun seems to contribute in the prevention – and in certain cases in the cure – of certain illnesses such as diabetes, tumors, heart-diseases and sclerosis. Furthermore sun rays help regulate our skin’s cellular renewal, and have a disinfectant action that reduces skin infections (Dr Maurizio Cutolo, University of Genova, Italy).

And that’s not all. Regular sun exposure keeps our retina healthy and may even prevent myopia. Sunlight is also a key factor in the production of the hormone (leptin) that controls our feeling of satiety and reduces our appetite. Yeay, a new good buddy in the battle against munchies and round tummies! And last but not least, sunlight regulates our mood by acting on our production of melatonin and serotonin. So much truth in the song « my sunshine, my only sunshine, you make me happy when skies are gray » !

The end of summer is really a time of transition and transformation for us all. Under the goose bumps our skin is still glowing with last month’s sun , we’ve put our jackets back on but still wear our sandals, our kids go back to school, we start new projects at work, hang out with our colleagues again, recover or change our routines and rhythm.

And if it wasn’t yet the case, well it’s time for your rhythm to include a regular “beat” for pampering and taking care of your skin. I mean, for example, to visit FOREVER LASER INSTITUT in order to touch base with your Doctor or Beautician, and redefine a treatment plan for 2012-2013. Indeed, it’s just the right time to:

• resume your laser hair removal sessions (one reason to be happy about your fading tan)
• start a series of post-sun peels
• plan a lymphatic drainage therapy (to eliminate left-over toxins from all those outdoor aperitif drinks)

So while the “sweet sorrow” of our summer almost gone is lingering, let’s jump together in the fresh waters of a new season!

To do so, I have interviewed 3 doctors:

1. my father, dermatologist, Dr. Luigi Polla,
2. a plastic surgeon, Dr. Emanuele Bartoletti,
3. a phlebologist, Dr. Andrea Alessandrini.

All three are experts in aesthetic medicine with over 20 years experience. Although they are of same age (between 50 and 60), same nationality (Italian) and share the same passion for aesthetics, they each bring interesting and personal comments to the theme: botulinum toxin on young adult patients.

Cyrille Polla : In your medical practice do you have a demand for aesthetic injections (fillers, botulinum etc.) coming from a young adult clientele between 22 and 30?

Luigi Polla : Yes, about 10% of my clientele for injections is between 22 and 30.

Emanuele Bartoletti : Not much, and never under 25-28 years old.

Andrea Alessandrini : Yes, I receive young adult patients with aesthetic expectations that have nothing to do with ageing, but more with beauty and self-confidence.

CP : What is the social and medical profile of your young adult clientele ?

LP : They are professionally active and financially independent with a good purchasing power. A third of these young women have an elder sister, mother or girlfriend as a confidant and “accomplice” with positive experiences of medical aesthetics. Another third has already come to consult my practice for other treatments such as peels and laser hair removal.

CP : Are the injection techniques, points of injections and number of botulinum toxin units injected different for a patient in her twenties as for one in her fifties ?

LP : I usually inject smaller doses on younger adults. However the features, muscle activity and other specificities of a face are more important than age when deciding how and how much botulinum I inject. Regarding frequency of injection sessions, I perform maximum 2 per year on a younger adult whereas the injections may be repeated up to 3 times per year on a woman over 40.

EB : No ; these three variables depend on the patient and her facial characteristics and have nothing to do with age. The recommended frequency is always the same (i.e. intervals of 4-6 months between two injection sessions) in order for the muscles to entirely recuperate their contraction function and to avoid risks of muscular atrophy.

CP : Do these young women come back regularly for their botulinum injections ?

LP : Usually they come once in a while, with no regular pattern. Their demand is more anecdotic.

EB : Not really. I noticed they usually come for special occasions, like before a wedding or graduation.

CP : Do you notice a taboo around the topic of botulinum injections on young adults between 22 and 30 ? Do you feel it in the media, with your patients and/or colleagues ? If so, why is that ?

LP : Yes, I feel the taboo at three levels : social, medical and in the media. This taboo is linked to the fact that botulinum is a drug and that it is associated – although wrongly – to the notion of habit and « addiction ».

EB : I notice the taboo when interacting with the media or with certain of my patients, but not when I discuss the issue with colleagues. The word « toxin » does not scare as much anymore, but there is still a fear of the « frozen » look after injections of botulinum, which means fear that the doctor injects too much or in the wrong muscles.

AA : Indeed, there clearly is a taboo, but I don’t think it is linked to patients’ age. Injections on older patients are as controversial.

One of the reasons explaining the taboo around botulinum injections on young adults is the idea that they will automatically have to continue the treatment for their whole life to maintain results. But actually, it’s the opposite; when botulinum is injected on patients in their 20s and 30s, there is a “muscle memory” effect which means that after a couple of sessions, the hypertonic (overactive) muscles will lose their habit of over contracting. The doctor may then discontinue or reduce the frequency of injection sessions, while results will continue to be visible. So previous wrinkles and lines won’t automatically reappear.

CP : Do you think that starting botulinum injections in your twenties will slow down the process of facial wrinkle formation?

LP : In a zone of muscle hyper tonicity, yes.

EB : Yes, absolutely.

AA : Yes.

CP : Apart from that benefit, do you think botulinum injections can have other effects, positive or negative, on the skin and general ageing of a face ?

LP : There are no case studies that allow me to express an informed opinion.

EB : No.

CP : What is your personal viewpoint and approach regarding the demand for botulinum injections coming from young women (22-30 years old) ?

LP : As a doctor I commit myself to answer with intelligence, ethic, and level-headedness to each demand, whatever the patient’s age; as long as the patient is adult, well-informed and fully conscious of the treatment in question. To refuse discussion amounts to keeping a certain power over younger generations, which is not something I believe in.

EB : According to me, the major quality of botulinum injections is not to erase wrinkles, but to enhance the beauty and expressions of a face. However I do not perform them on patients under 25 years old.

AA : Botulinum toxin is not an anti-age product per se. Rather, it allows improving the appearance of a face, to correct certain asymmetries and mimics. These are aesthetic preoccupations that exist also in patients under 30. So when their request is thought-through and justified, I have no reason not to perform botulinum injections.

CP : When do women start to perceive their own ageing process ?

LP : Between 30 and 35 years old ; often, that’s when the start to identify themselves to their mothers.

EB : Around 30.

AA : The demand for ageing prevention appears around 30-35. I noticed that external factors might influence the timing, like a heartbreak for example.

CP : These young women between 22 and 30, what are they aspiring to ?

            a) age prevention

            b) feeling more beautiful

            c) taking care of themselves and their self-esteem

LP : Above all there is a desire to feel better about themselves.

EB : Feeling more beautiful and attractive.

And what about you, what do you think ?

FOREVER’s on your side, Mesdemoiselles at heart and in spirit. What exactly can we do for you? Quite simple: make you want to pamper yourselves, feel good about yourselves and preserve your fresh and colourful looks forever.

A few treats to try:

• A peel to get a glowing skin before a night out

→ enjoy the pink cheeks and even skin tone of a Mademoiselle without having to go heavy on blush and foundation

• A lymphatic drainage for thin and light legs before a shopping spree around the city

→ enjoy wearing your heels all day long like a Mademoiselle

• Hyaluronic acid for beautiful lips free from signs of bitterness or tightness

→ enjoy applying lipstick on that perfect pout and …

A little over a year ago, in December 2010, the newspaper Le Temps dedicated 3 pages to Dr Polla, featuring an exclusive interview. The big question : what will be the trend in 2011 ?

Dr Polla’s answer :  « The trend in aesthetic medicine that I foresee in 2011 is what I call « Slow and Sustainable Beauty ». He explains this concept of « slow beauty » from his patients’ point of view : a conscious and respectful quest for beauty, with a long term vision. For example, patients compose a 6-12 month treatment program with their Doctor, favour soft techniques that preserve their physical and emotional integrity, and want to age in a natural and dignified manner whilst staying fresh and attractive.

And now let’s look at ELLE’s page 93 : « Slow beauty is the hot trend for 2012 », « it’s about combining techniques, spacing-out treatment sessions, gentle and comfortable procedures that offer natural and progressive results ». So we all agree, and Forever Laser Institut is proud to have ELLE validate its word.

Dr Polla, visionary and realistic, inspired and competent, master of his field, anticipates the trend ! You are in good hands, and he shows the right way !

So Doctor, what about 2013 ; what do you see in the stars of beauty ?

The story

Dermatologists have long known that in winter, horseback riders who practice in jeans risk atrophy (reduction in volume) of fatty tissue on the external sides of their thighs. Why specifically those wearing jeans? Because unless they are baggy or boyfriend-jeans, original denims are tighter and their fabric doesn’t stretch like professional horse-riding pants; they hinder blood circulation and hence prevent that part of the body to stay warm when outside temperatures plummet.

The Research

This phenomenon sparked Professor Rox Anderson’s (Harvard University of Boston, Dr Polla’s former teacher and mentor) interest as to the reasons for the fat tissue atrophy. His research lead him to draw two conclusions:

1. fat cells are more sensitive to cold compared to other cells,
2. if an “accident” produces such results, then a controlled cooling of these same fat cells could allow their destruction, without restoring to surgery.

The Device

Twenty years after having patented the idea, technological developments allowed the construction of a device capable of extracting enough heat form the skin and its underlying fat tissues to eliminate fat cells in a uniform way, without creating inflammatory responses. The technique was called cryolipolysis (cryo=cold; lipo=fat; lysis=decomposition). Zeltiq was the first brand to launch the “CoolSculpting” device. As always, Forever Laser Institut was the first Swiss medical centre to offer the cryolipolysis technique. Our patients, both male and female, have benefited from this revolution for more than 18 months now, and have all been very pleased with the results.

The Results

The great thing about inducing a controlled thermal injury to fat cells (in this case with cold), is that it triggers a process of “programed cell death” with no inflammation. This type of “natural” cell death is called apoptosis (opposite of necrosis). It is the same type of reaction that occurs, for example, when a pulsed dye laser is used to destroy damaged blood vessels in the treatment of rosacea.

It is important to note that during a cryolipolysis procedure, the skin of the treated area is left intact (i.e. it is not damaged by the cold the way fat cells are). Indeed, a temperature lowered at 5°C affects only fat cells. When in apoptosis, these targeted fat cells will be progressively eliminated by natural metabolic processes over the 2 months following the cryolipolysis procedure. That’s when the centimetres will start shedding off the waist, hips, thighs, or any other treated area. For those patients whose skin has lost some elasticity and tone, we recommend a couple Titan sessions to firm-up those areas. Cryolipolysis is particularly effective on love handles, tummy fat, flabby upper arms, or above the knees, where the fat bulges are usually easily “sucked-in” the device’s hand-piece.

Super Cool!

So it’s no joke! In 1 hour, with no side effect or downtime, you can get rid of those rebel fat bulges. Cryolipolysis is the first non-invasive but equally effective alternative to liposuction. So don’t wait any longer and book an appointment with Dr Franz, our specialist in body treatments. And even if bikinis are resting at the back of our drawers for the moment, don’t forget that taking care of our silhouette should not be a seasonal matter…

We all know now that to preserve our health and good looks, reducing our intake in fatty foods is a non-negociable rule. Magazines, TV, our doctors and favorite bloggers have exposed and explained, each in their own way and language, the damages that saturated fats cause to our cells, organs, and bodies. So as good citizens, we have learned to replace butter by a spritz of olive oil, steam-cook instead of deep-fry, chose yogurts, cheeses, ice-creams whose lipid contents are close to zero. Very well. But what about sugars? Just by their sweet name they seem less harmful than the „ugly“ fat. We have all indulged in the oh-so-chic macarons, cupcakes, and other fancy and cute deserts that are out there. Just when we have started to accept (not so difficult, in the end!) the fact that a girl eating desert is sexy, a new scientific discovery comes to light.

During the Winter Academy of Dermatology held in Saint Moritz, specialists from all over the world exposed and discussed the negative effects of sugars on our skin. They called « AGE », acronym for Advanced Glycosilated End-products, the toxic molecules that are produced when the sugars we ingest denature the precious proteins we are made of. In other words, glycation is the chemical reaction where the sugar in our blood bonds to our proteins, thus creating AGE. We know that our skin is composed of many important proteins like collagen and elastin. We start to see where these scientists are going : AGE are our skin’s enemies. Why ? Because they create bridges between our collagen fibers, that become rigid, thus « freezing » our wrinkles and making our skin lose its elasticity, and so accelerating its ageing process.

Ok, enough with the scientific jargon, their unanimous conclusion is that even though all sugars may potentially lead to such devastating mechanisms, there are some sugars that are more harmful than others. Basically the two « good » sugars we may eat without stressing our skin are fructose and honey. Once again, the Mediteraneans are the winners, with their abundance of sun-blushed juicy fruits and their post-dinner sweets made in major part with nuts and honey, like for example the Chebakia (Moroccan sesame and honey cookie). But there is one third non-toxic friendly sugar, that actually « repairs » aged skin. It’s name may be familiar to you: Haluronic Acid. Ha ha! I refer to it as « HA », for how HAppy it makes us, for establishing good HAbits, for  he HArmony it restores to our face, for how HAndsome it can make us look, or just for HAve some more!! Yes, we are allowed, and even advised, a new sugar-fix.

Nowadays, HA is used with great success in rejuvenating injection techniques (Softlifting). It really works wonders. Injected through a soft, blunted and flexible micro-cannula, following very specific patterns, and in a broad dispertion, it restores volume, moisture, luminosity and firmness to the skin. Indeed, the list of positive physiological properties of HA is very long, and it includes the stimulation of skin cells’ activity, of collagen production, of hydration of skin tissues, and of free-radical quenching. Doesn’t that sound wonderful. And the extra perk is that the procedure is painless, and does not induce recuperation time of any kind. In the doctor’s office, and two hours later, back to sweet life…

So ladies and gentlemen, the final words are : what you feed your skin is as important as what you put – or don’t put – in your plate. The secret is craving for the “right” sugars !