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« Dr. Kevin D. Light: Cosmetic Surgery & Anti-Aging Medicine In Dallas, TX | Main | Dr. Todd Schlifstein On Integrating Medical Spa Treatments Into A Wellness Center »
Monday
May142012

How To Use CT3+V: An Equation For Creating Facial Beauty

CT3+V = A simple equation for creating or restoring facial beauty.

We all know that "Beauty" is in the eye of the beholder. When it comes to creating and restoring facial beauty, we collaborate and negotiate with our patients (and sometimes their family and friends) to optimize the result and reduce the risk by using more conservative aliqotes of different techniques and technologies. Each practitioner brings their own unique skill-set and biases to the procedure room. We (hopefully) listen to the patient requests, evaluate what the underlying structure, tolerance for downtime and discomfort, economic consequenses and duration of effect is, to be able to offer the patient a scientifically valid, safe, sensible treatment plan. Then, we present a palette of procedures, techniques and technologies to consider.

What sets successful docs with many happy patients apart from the rest of the competition is attention to detail, listening to their patients (and sifting out the unrealistic ones) and having a plan that is recreated in some form (it's never the exactly the same twice) again and again.

My equation (tool) for discussing and creating facial beauty (or re-creating a more youthful appearance) is CT3+V = Beauty... short for Color, Texture, Tone, Tightness and Volume (in proportion or re-establishing proportion)

When the patient (on request) brings pictures of their face and neck that show them in yourthful repose, it is a strong tool to build consensus of what procedures and when in the scheme of possiblities, to pursue. Compare the old photos to current digital pictures obtained in 5 views-front-quarter and side views against a solid background with decent lighting and a portrait lens. Now diagnose the changes and educate the patient on the many ways you have to enhance and revitalize the issues you uncover in a systematic manner:

Color-pigment mottling and broken blood vessels respond well to various IPL's, NdYAG's, PDL's and KTP lasers depending on the patient's heritage (Fitzpatrick or Lancer skin type);

T3 (Texture, Tone and Tightening)-decide if the issues are epidermal, dermal or sub-cutaneous and treat with chemical or laser peels, focused ultrasound or radio-frequency and remember the skin looks better when "on-stretch", so Volume and surgery fit here too.  Toxins soften the dynamic wrinkles and shape the brow, but should be delivered in a artful manner that yields a natural, rather than "done" result;

Volume-Pierre Fournier, MD (Paris) taught us that "the look of youth is full" and the current saying "size matters" comes in to play here too.  Youthful features are generally softer and rounder, age makes them more severe and hollow.  Surgery helps take the luff out of the sail or the sag out of the jowl and neck, but does not effect volume very effectively.  Volume is at least as (and maybe more) important long term.  Fat and fillers (I prefer fillers for face) are a great way to go as long as you educate the patient as to how much it will really take and offer them permanent fillers (like Artefill in the USA) that can serve them well long term, once they find the look they want to preserve.

So-with every patient: define the issues, make a mutually agreeable long term plan, track the progress with digital pictures and keep an open dialog and flexibility, so that both you and your patient achieve happiness and WOW results long term. Happy patients refer their friends. Surviving aesthetic medicine these last 15 years is no accident....it's all been done with mirrors and this equation!

Reader Comments (3)

Hello Dr. Zimmerman, I'm guessing that you're also putting all of your patients on a product regimen with something that hydrates (if only temporarily) the dermis? Are you seeing any difference in any product on the market? Right now I'm just suggesting that patients use any daily moisturizer but I'd be interested in others opinions. I haven't really seen any differences in benefits other than hydration but I'm open to opinions.

05.14 | Unregistered CommenterLars MD

Yep. Got that right Dr. Lars. Everyone gets their own special topical regime with sunblock and moisturizes to deal with our dry, high desert climate in Vegas. (or variations if they are from out of town). We also address nutritional, hormonal and supplement deficiencies that can contribute to skin, volume and healing issues. Major Pigment issues deserve Vit D3 at 5000 units/day (check a level if you like, but almost all of us are deficient of this fat soluble vitamin) and a topical that bleaches, inhibits tyrosinase and decreases inflammation. Poor healing-check a tissue carotenoid level and get them on decent anti-oxidants and a nitric oxide activator to dilate those supply vessels; SyndromeX-don't ignore it, treat it...as so forth...that's the joy and the curse of medicine...so many variables contribute to issues and we've just begun to understand some of them!
Thanks for your good points. BTW, we make our suppliers prove their value by doing half face tests of one against the other cream on staff and friends of the practice till we find something that seems to be really good and not hype.

05.14 | Unregistered CommenterDr. Z

Super good stuff and exactly on point Dr. Z. (I'm assuming you're Dr. Zimmerman, the post's author, but I can't see your photo/byline.) I'm curious as to what the reps tell you when you make them do half-face tests... poor sods.

05.14 | Unregistered CommenterDermgal

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