The “Non-Invasive Face
Lift” - Facts and Information
Information provided by
Newport Beach MedSpa
- A Personalized Approach
The laser like infrared-light device is held
on the skin and, as it slowly passes over the
area being treated, delivers a series of quick,
heated zaps that reach below the surface to
repair and stimulate collagen. In fall 2003,
aesthetic laser and light company Cutera began
developing Titan because at the time, it saw
few real alternatives for patients who wanted
to look younger but did not want an invasive
procedure. Titan was created with those scalpel-
and needle-wary people in mind, as it works
to treat sagging skin without changing its inherent
structure. In October 2004, the FDA declared
the system safe and effective for heating the
skin, and the company expects to have FDA clearance
for wrinkle reduction as early as this fall.
does it work?
The natural aging process, along with sun damage,
cause collagen fibers to stretch and loosen
like worn rubber bands, resulting in less elastic
skin that eventually droops. Titan tackles this
problem by delivering infrared light deep into
the dermis, the inner layer of skin where collagen
resides, and prompting the collagen to repair
itself. The light works in two ways: It heats
up the weak collagen, causing it to immediately
contract and thicken, and it also creates micro
injuries to the dermis, encouraging it to produce
new collagen over a period of months. The result?
A smoother, tighter, more toned look that occurs
naturally, as opposed to with fillers, muscle
freezers or physical alteration of the skin.
But perhaps one of the biggest draws of Titan
is that it is almost painless, a major difference
between Titan and its predecessor, ThermaCool,
also known as Thermage, a skin tightening system
first launched three years ago. Though both
systems work by heating the dermis and contain
cooling devices within the hand pieces that
continuously control the temperature of the
skin's surface, ThermaCool uses radio-frequency
energy, which dermatologists claim is much more
intense and harder to control than light energy,
possibly making the treatment quite painful.
Radio-frequency energy can also go to deep,
destroying fat under the skin and resulting
in dimpling, unevenness and skin depression.
"With Titan, there is no risk of skin irregularity
because it doesn't go deeper than the dermis,"
says dermatologist Bruce E. Katz, M.D., who
participated in the FDA clinical trials for
can it be used?
Titan is appropriate for any area of the face,
neck, or body where there are wrinkles or mild
sagging caused by loose skin, such as the brow
region, cheeks, jowls, neck, abdomen, thighs,
back of arms, elbows and knees. However, doctors
are debating where the best results occur. Because
the technology is so new, different dermatologists
are test-driving it in different areas, but
all agree that it produces real results - in
the right situation. "Titan is not meant to
replace a full-blown, invasive facelift or a
tummy tuck," says Katz. "It's not going to work
well on very loose skin. The best scenario is
to use it on areas that still have some elasticity
but are starting to slacken." Yet dermatologists
admit that Titan can make a difference even
on less-than-ideal subjects. "If someone is
a candidate for surgery but doesn't want to
have it, she will get some improvement from
Titan," says Goldberg. Two areas where doctors
are seeing good results are the knees and elbows,
regions that, until now, were virtually untreatable
for drooping skin. Where it is ineffective is
on the skin that is uneven due to excess fat,
such as the butt, an area that few doctors are
treating with Titan because "it's going to work
only if you have loose skin," Katz explains.
"The problem in the butt is usually bulging
fat, which Titan does not treat." Some dermatologists
are using the treatment in combination with
other cosmetic procedures to enhance their results,
such as to tighten skin post liposuction. Brandt
is currently conducting a study in which Titan
is used on the neck after Botox is administered.
"We want to see if by relaxing the muscles first,
Titan has an even greater effect because it
is operating against less downward resistance,"
is the best candidate for it?
Doctors are finding that age is not the determining
factor in Titan's success. They stress that
it's more about the condition of the skin and
tackling the problem when the first signs of
sagging start to occur, which differs from patient
to patient. I've had people in their late 20s
with modest results and people in their 70s
with great results," says Javier Ruiz-Esparza,
M.D., a San Diego dermatologist who took part
in the Titan FDA clinical trials. Tough doctors
agree that collagen doesn't respond or form
as well after the age of 50, they maintain that
mature patients can still achieve favorable
results - if they have taken proper care of
their skin. "It's not about your chronological
age but your biological age," says Brandt. "Someone
who has stayed out of the sun and treated her
skin well might see results, even if she is
older, because there is less damage to repair."
happens during the treatment?
Forget having to clear your calendar - Titan
truly seems to be a lunchtime procedure. It
takes anywhere from 10 minutes to one hour depending
on the size of the area being worked on and
the meticulousness of the doctor performing
the procedure (many treat the same area two
or three times in one session). There is almost
no pain involved and nearly no side effects
save a bit of redness that typically lasts an
hour or so and a slight swelling that usually
subsides after a day or two. Doctors and patients
agree that you can go right back to work post-treatment,
with your colleagues none the wiser. "I am probably
the only one who even noticed the swelling,"
says Carolyn. "I actually liked it because it
made my face look a bit more plump!" A topical
numbing cream is applied to most patients beforehand,
though several doctors claim it isn't needed.
The hand piece, which looks like a small vacuum
head, hits about one square inch of skin per
zap, and each one lasts about six seconds. The
sensation feels like a surge of heat that comes
and goes. "It's more discomfort than pain,"
says Carolyn, whom Brandt treated with numbing
cream before the procedure. "It feels like a
concentrated heat, but it's not that bad." The
company claims to no reports of long-term side
effects, though it has heard of a few patients
experiencing mild blistering immediately afterward
that resolves itself with a few days. Ruiz-Esparza
says that about 3 percent of his patients have
experienced this, "but the blisters go away
quickly and are more of a nuisance than anything
How many sessions are required?
Doctors are divided as to how often the
procedure is needed and how far apart the sessions
should be spaced. The average recommendation
is one to three treatments performed two to
four weeks apart. Katz advises up to five sessions;
while Ruiz-Esparza suggests only one and lets
his patients decide whether they want to continue
with it. Most doctors conclude that it depends
on the person's needs and the area being treated.
Quite a few space the sessions one month apart,
but Katz feels strongly that Titan should be
administered every two weeks. "The skin produces
more collagen when the dermis is still little
inflamed, and if you wait a month, all the inflammation
goes away," he notes. "We're keeping up the
momentum." How often the entire series needs
to be retreated,: says Goldberg, "but we're
thinking every one to three years."
are results visible?
While many patients report immediate tightness,
dermatologists argue that it mat be from the
slight swelling of the skin post-treatment.
It takes three to six months for new collagen
to form, so optimal results should occur after
three to eight months, depending on how often
the treatment is repeated. The extent of improvement
varies. "We don't know why some patients get
better results than others," admits Ruiz-Esparza.
Brandt agrees: "It's too soon to understand
the long-term effects. We have to treat hundreds
of subjects to see all the good and negative
outcomes." Still, women are lining up to get
zapped, since there is so little risk involved
and the cost is relatively low compared with
surgery. "What's great about Titan is that it
doesn't preclude you from having surgery later
on," notes Goldberg. "But once you cut skin,
that scar is there forever."
and Filler Therapy
Cosmetic, Juvederm and Radiesse
The way your skin looks is directly related
to the way your skin is supported. As we age,
the natural support layers in the skin break
down resulting in the formation of wrinkles.
With these simple, highly effective procedures
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these low invasive treatments can bring dramatic
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