Cosmetic medicine

Overweight and obesity: the place of cosmetic medicine:

Your health and beauty are precious allies. Your team is there to guide you every step of the way.

Cosmetic procedures do not necessarily mean serious surgery; for a number of years now, cosmetic surgery has been using substances that can usually be injected and state-of-the-art technology to achieve spectacular improvements in patients’ appearance.

Accepting and treating excess weight is an important and special time to take stock of one’s body. But variations in weight are not without consequences for the skin and soft tissue. Slack skin, premature or more obvious wrinkles, cellulite and hair loss are all signs.

Simple, fast and effective, used alone or in conjunction with cosmetic surgery, the treatments offered by cosmetic medicine nevertheless require a high level of technical skill and precision, which alone can guarantee results.

A quick look at the treatments offered by this “gentle” medicine.
  • Skin treatment: blemishes and other skin deterioration (rosecea, blotches, scars, shallow and deep wrinkles) can be unsightly and a number of solutions are possible, ranging from peeling to laser treatment.
  • Cosmetic mesotherapy is far from new and the technique of local injections has become a favoured friend in cosmetic circles. This treatment addresses slack skin, orange-peel skin and hair loss.
  • The medical treatment of wrinkles: There are many treatments for overcoming, relaxing and doing away with wrinkles, but our preference goes to resorbable products as they have the advantage of leaving no trace if the treatment is not satisfactory for the patient.
  • The medical treatment of hyperhidrosis or excessive sweating.

Focus on the various techniques :

Cosmetic mesotherapy

The technique is not new and was developed in the 1950s by Dr Michel Pistor. His main aim was to get as close as possible to the problem or pain and treat it with a minimum of undesirable effects. The originality of this method stems from the way it is administered, which consists of local intradermal (into the dermis, just under the surface of the skin) injections of a medicinal substance using a syringe and a fine needle. Its interest lies in repeated injections and the use of small quantities of substances that have a therapeutic or cosmetic effect

Use of this technique for cosmetic purposes has enjoyed growing success in recent years.

What are the indications?

Mesotherapy is ideal for treating ‘orange-peel’ skin (superficial cellulite) and heavy legs, which are often associated with excess weight. For slack skin, the term “meso-lift” or skin rejuvenation is used. It is aimed at people who want to prevent the appearance of the first signs of slack skin. The aim is to feed the dermis and stimulate the growth of cells by treating it actively with micro-injections designed to repair damaged skin tissue. Mesotherapy is ideal for revitalising, rehydrating and providing a younger and more elastic look to the skin. Skin with fine wrinkles or dehydrated by to much sun, tobacco and some medication, can be treated to good effect by mesotherapy of the face.

Whether it is for treating cellulite, heavy legs or improving the condition of the skin, the results will only really be effective if the treatment is applied with sufficient regularity, hence the interest of maintenance treatment.

Medical treatment of wrinkles

There are two type of wrinkles: expression wrinkles and constitutional wrinkles.

Expression wrinkles (crow’s feet, forehead, lines between the eyebrows): these are caused by excessive muscle contraction. Botulin stops the muscle from contracting excessively, thereby preventing the wrinkles from appearing.
Botulin is a natural protein produced by a bacterium. A tiny amount of this protein is injected into the muscle fibres that cause dynamic lines to appear, such as frown lines and crow’s feet. This substance temporarily blocks the transmission of nerve signals to the muscle fibres, relaxing the muscles being targeted. As a result of this relaxation, the skin also relaxes and takes on a smoother appearance. The treatment only takes a few minutes and patients can resume their normal activities immediately. The effect only becomes visible after a few days with a natural result. If any side-effects occur, they are always short-lived and never severe. The skin retains its smooth appearance for up to 4 months after the treatment and a more long-lasting effect can be achieved after a number of injections. This is currently the treatment of choice for wrinkles at the top of the face.

Constitutional wrinkles of the face (furrows from the nose to the corners of the mouth, deep lines, fine wrinkles) can be treated by injecting filler products of various origins: animal, bacterial, human or synthetic substances. A distinction is made between products that have a temporary, semi-permanent or permanent effect. Our preference goes to products with a temporary effect and the ones with the best safety profile are collagen and hyaluronic acid.

1. Hyaluronic acid

A natural constituent of our dermis, hyaluronic acid is, with collagen, an essential constituent of our skin, forming a “mattress” on which the epidermis rests. As we age, it is produced less, resulting in the formation of wrinkles and furrows. To overcome wrinkles, the product most often used is hyaluronic acid produced by genetic engineering. These products are non-allergenic and tests in advance are not required. With excellent hydrating and restorative powers, hyaluronic acid really does slow down skin ageing. There are different types for treating superficial and deep wrinkles.

2. Collagen

At one time, collagen had virtually disappeared from our arsenal of treatments because of its risk of causing allergies and the possibility of transmitting viral disorders. Today, using an innovative new production technique (in vitro production of collagen from pig matter, followed by a reticulation process), collagen has been restored to its former glory and can be injected in total safety without the need for allergy tests beforehand.

Hyaluronic acid and collagen can of course be used to treat wrinkles, skin furrows and scars, as well as to restore volume to sunken cheekbones, cheeks and lips, which is particularly interesting for people who have lost weight or whose face has lost some of its youth.

Which filler product to choose is something to discuss on a case-by-case basis with your doctor.

Skin treatment

As we have already mentioned, other types of deterioration to the skin may be unsightly.

Pigment stains, some scars, wrinkling and acne may benefit from a peel (chemical exfoliation).
During the peeling process, products are used to remove the upper layer of the skin. These products are used to smooth rough skin and improve the texture of skin damaged by the sun. After chemical exfoliation, your skin will be smoother, more firm and have fewer and more shallow wrinkles as well as a more even complexion. The procedure can be superficial or more moderate in depth, depending on the number of layers to be removed. Natural exfoliants extracted from fruit and plants (AHAs and BHAs) are surface exfoliants. They remove the upper layer of the skin (epidermis) and provide a slight stimulus for the formation of new collagen. Moderate exfoliants contain trichloroacetic acid (TCA) and remove the epidermis and the upper part of the dermis. After this type of treatment, your skin will be red and puffy, sometimes with a few small scabs. It may take up to two weeks for the skin to regain its normal appearance, after which time you will benefit in full from your new fresher, smoother look. Maximum sunscreen protection is absolutely essential throughout this period.

Rosacea and red face blotches

There are currently three main techniques for improving rosecea and blotches, which are usually located on the nose and cheeks. This redness is caused by dilation of the capillaries in the upper layer of the skin.

1) Sclerotherapy

Sclerotherapy enables the larger blood vessels to be treated. It involves injecting very small quantities of sclerosing product into these vessels using a particularly fine needle. The walls of the blood vessels then fuse and as they no longer contain blood, they can no longer be seen. Usually, 2-3 sessions of sclerosing injections are needed to reduce the redness of the most visible blood vessels. After-effects are limited to a little redness for a few hours, and sometimes some minor bruising, which disappears in a few days.

2) Electrocoagulation

The most classic technique used is electrocoagulation, which can treat minor blood vessels for rosecea as a complement to sclerotherapy. A fine electrode is placed on the skin, by the blood vessel, which is coagulated by heat, point by point, along its length. To avoid discomfort, it is recommended that an anaesthetic cream be applied before the treatment. A number of sessions are required to make any significant improvement to an area of rosecea.
The electrocoagulation points remain visible for a few days, either as red dots or as tiny scabs the size of a pinhead.

3) Vascular lasers

The weakness of the two treatments above is that they have problems in overcoming more diffuse red blotches which are difficult to treat individually as the vessels are too fine. In the past few years, though, new lasers can now correct these diffuse blotches. These are KTP or pulsed colorant lasers. Of course, these lasers are also only able to treat the larger vessels in the rosecea, but require fewer sessions, 2 on average, because the whole area can be treated at once.

What happens after treatment?

Rosecea is linked to multiple factors such as irritated skin, poor circulation, attacks by the weather or pollution, alcohol, being emotional, tobacco, etc.
All of these treatments aim at making the unsightly aspect of rosecea disappear and avoid aggravating it. But the causes are still there and the redness will return over time. However a top-up treatment every 1 to 2 years or more will enable the result to be maintained.

Treating hyperhidrosis (excessive sweating)

At one time or another we all have to cope with a problem of excessive sweating. It can have a number of causes: stress, heat, physical activity. The term hyperhidrosis is used to designate excessive sweating that is inappropriate for our physiological needs. It affects about 1% of the population and may occur in certain parts of the body or all over. Its effects may be amplified by obesity. There is currently no treatment that permanently suppresses excessive sweating. But a revolution appears to be coming from botulin, which when injected locally, cuts out excessive sweating for long periods of time (up to 6 months and providing relief for 95% of patients).
The botulin acts by destroying cholinergic transmissions of the sympathetic nervous system. These transmissions re-establish after four to six months. Injection botulin is especially effective for sweating of the underarms, palms of the hand and soles of the feet. The method does have some contraindications: women who are pregnant or breastfeeding, patients taking certain antibiotics, certain neuro-muscular conditions, etc.).
The treatment takes a few minutes, and to avoid discomfort when treating the underarms, an anaesthetic cream can be applied to the area to be treated. For the soles of the feet or palms of the hands, a local anaesthetic is required, administered by an anaesthetist. One treatment session is required every 4 to 6 months. If the hyperhidrosis does not respond to botulin (which is very rare), and is genuinely handicapping, surgical treatment is possible to help combat the sweating.

Cosmetic consultations and medical procedures are not reimbursed by Social Security.

Dr. Moens Danielle
Responsible for “Nutrition”
and “Cosmetic Medicine”

No current news