Idebenone

Aging begins the day we are born--and continues progressing until the end of our lives. Aging is an inseparable part of life. Our lifestyle choices are a major contributor to the manner and speed at which we each age. Thus, it is no surprise that methods or therapies that produce "anti-aging" or "age-reversal" outcomes are a topic of universal interest. For the men and women who practice the science and art of cosmetic surgery, anti-aging is a perennial "hot topic," as well.

While we all must age, the rate and nature of the process is variable and individual. New insights into how the skin and body age are emerging at a rapid and accelerating rate, thanks to diverse institutional, corporate and private clinical research activities as well as recent advances in molecular biology and genomics. Scientific advances are unlocking the mysteries of aging at a cellular level. Ultimately, as these discoveries are translated into practical anti-aging therapies, our patients will experience the harvest of these research endeavors. Recent innovations are already beginning to provide us with unprecedented new techniques and therapies to combat the visible signs of aging.

As cosmetic surgeons we tend to look at the end result of the science and research after these discoveries become tools and prescriptions. However, sorting through the growing and sometimes bewildering array of new products and therapies is already a somewhat daunting task--one which is rapidly becoming more challenging as the rate of discoveries and new knowledge continues to accelerate. Products are introduced for the most part with no side-by side comparison data to help us to discern the best choice for our patients. Cosmeceuticals with increasingly drug-like effects commonly enter the marketplace with little or no clinical data at all.

The recent American Society for Laser Surgery & Medicine meeting featured novel technologies and treatments that enhance the options available to cosmetic surgeons. Among these are laser skin resurfacing-like benefits produced by a no-downtime, minimally uncomfortable procedure based on the concept of "fractional" laser exposure, which creates patterns of microscopic laser hits over a portion of the skin area treated. A unique, rapidly healing wound is produced, which after a series of treatments creates a resurfacing-like effect on the skin surface as well as subsurface collagen remodeling.

Low energy, non-thermal LED photomodulation was shown to minimize the effects of acute UV injury and to provide improvement of the appearance of photoaged skin, including skin tone, pore size, fine lines and elastosis.

At the recent American Academy of Dermatology annual meeting, "second- or next-generation" cosmeceuticals were introduced. One new topical antioxidant, idebenone, is a synthetic derivative of the naturally occurring ubiquinone or Coenzyme Q10, but possesses significantly greater potency. A new, very broadspectrum sunscreen ingredient, mexoryl, is available in Europe and appears to provide excellent protection from photoaging, including protection from mid range UVA rays for which sunscreen protection has traditionally not been as effective. (UVA rays are responsible for stimulating dermal matrix-degrading enzymes and contribute to skin sagging as well as other visible signs of aging in the skin.)

New skin-analysis technology has produced a tabletop photographic device which can digitally analyze skin for fine lines, age spots, pores and even acne bacteria via imaging porphyrin fluorescence in sebaceous glands. This device provides the cosmetic surgeon with the ability to compare the results of the analysis of the skin of their female patients against a database of women of similar age and ethnicity and rank them according to severity, compared with their peers. (Sorry, men, but a male database is promised in the future.)

The year 2004 appears to be the year of the parade of dermal injectable fillers, with many "new faces" appearing in the United States (some of which have been on the "menu" in other countries for quite a few years). Longer-lasting fillers which do not require skin tests are proving extremely popular with patients, and more "permanent" fillers are on their way. If that wasn't exciting enough, autologous injections of a patient's own fibroblasts taken from a small skin biopsy from behind their ear can be isolated and multiplied and then later injected into wrinkles, furrows or acne scars. This therapy is showing some dramatic results--especially for ache scars--in clinical trials. Botulinum toxin A is admittedly not a "new face," but its soaring popularity is one more indication that "anti-aging" cosmetic surgery is booming.

Altering or modulating the activity of genes that code for cellular activities is now possible. The ability to use a cheek swab to analyze a patient's genetic predisposition to various factors which affect aging is being introduced. Watch for more genomic based clinical innovations to appear in the near future.

The future for anti aging therapies has never been brighter--and practical applications of these and other new scientific developments for our patients are rapidly increasing. People want treatments that are safe and effective, and provided by experienced and trusted cosmetic surgeons. The pursuit of excellence as cosmetic surgeons now requires increased understanding of these new developments in order to optimally design our patients' Anti-Aging Rx--an individualized program for skin health and fitness which will last a lifetime.

COPYRIGHT 2004 Advanstar Communications, Inc.
COPYRIGHT 2004 Gale Group