How to choose a cream for your face

My patients ask me for skin care advice every day. Many of them bring multiple bottles they've bought on QVC promising eternal youth. We go through them and most of them miss the most important skin altering ingredients. The science of anti-aging is actually very simple, and it doesn't necessarily come in a very expensive pretty bottle. It usually comes from a medical office that has a medical director or professional who is allowed to prescribe higher concentration potent vitamins. So next time you buy a potion make sure it has these ingredients:

Most important of them: Vitamin A (Retinol, Retin-A, Retinoic acid. Retinol Palmitate or Acetate, etc) It is scientifically proven to stimulate collagen production, diminish fine lines, lighten pigmentation, and repair DNA damaged by smoking, free radicals, tanning, and every day oxidative stres.

Second most potent vitamin is Vitamin C: very strong anti oxidant, skin brightener, but extremely unstable especially in the light. Vitamin C boosts the activity of Vitamin A, this combination is very effective in fighting aging. To stabilize Vitamin C many companies add another anti-oxidant Vitamin E. Skin Ceuticals patented a formula with A, C, E vitamins and plant-derived ferulic acid that makes this combination extra long lasting. Of course, the formula has been stolen and modified, so the cheaper version is available.

Glycolic acid-very mild acid that gently sloughs off dead cells and make your skin extra permeable for other goodies.

Hyaluronic acid (HA)-though not very stable, this gorgeous molecule attracts many many molecules of water and makes your skin glow with moisture. HA also composes many fillers (Juvederm, Restylane, Perlane, Belotero) that are used to fill in lines, plump lips, and diminish depressions under eyes (tear troughs).

Kojic acid-natural plan-derived bleaching agent that works on pigment in your skin and diminishes freckles and age spots. I got rid of my post-pregnancy melasma with it!
Hydroquinone-very potent bleaching agent, that I recommend using with caution, it is not approved in Europe but surprisingly FDA approved in USA. I recommend using short bursts of therapy for very stubborn pigmentation.

Peptides-agents that temporarily plump the skin. They don't alter the texture of skin like vitamins, but can make you look better for few hours.

Amazingly, Image skincare has all of those ingredients in most of their creams, serums, and masks! That's why I love that line and use it exclusively.
 

Why do I love Sculptra?

So, I'm pretty well known for using a lot of Sculptra in my practice. The truth is I use a lot of everything, but yes I can say I am a little biased when it comes to restoring the lost volume of the face. Most of you know fillers like Juvederm and Radiesse, they are temporary materials that can add volume where you need it instantly. Couple of complaints about fillers: you can often feel them under your skin (which most people actually don't mind, it looks smooth) and they can only be injected in certain parts of the face. If you know how the face ages it's easier to recreate youth. I always use an analogy of a filled ballon which deflates with time and saggs with gravity. The reason smile lines and marionette lines appear is not just loss of elasticity of collagen of the skin, but really the overall volume loss of the face.

There's also bone resorption with age and remodeling of facial bones. Interestingly, Sculptra can help here too as it can be injected deep to stimulate collagen production around the bone (cheekbones, chin, jawline).

There is a technique of correcting jowles by masking them with fillers. I feel that it makes the face less proportional and more masculine. I don't like using fillers in the lower part of the face for that reason (unless, of course, I'm treating a man or doing chin and jawline augmentation).
The difference between fillers and Sculptra is that the latter can be injected pretty much anywhere. Sculptra can lift jowly lower face rather than making it heavy like fillers. Sculptra is a suspension of chrystalls (that dissolve in few months) in water. It is distributed evenly where the volume was lost. Chrystalls create an illusion of trauma and your skin is "tricked" into thinking it needs to heal itself and produce collagen. The only "catch" with Sculptra is gradual injection: I usually would use a vial per treatment and recommend 2-3 treatments spaced 4-6 weeks apart. Collagen comes in slowly (which most people like as they don't have to explain a sudden change to co-workers and significant others) and lasts up to 2.5 years.

I very frequently use fillers and Sculptra together. Instant gratifying change from fillers is backed up by uniform collagen stimulation and lift from Sculptra. But I use both products equally as much, and there is time and place for all of them as I like to say.