How to Tighten Saggy Skin from a Dermatologist! | Dr. Shereene Idriss

good morning little nerds I am Dr Shireen Idris a board certified dermatologist I found this stacked in my closet and welcome to Pillow Talk Derm on my YouTube channel the reason I'm pointing towards this this is my board certification someone last week told me that they get annoyed when I introduced myself as a board certified dermatologist but the reality is today more than ever it is so important that you as a viewer know where you're getting your information from and by whom you're getting your information from because misinformation is rampant and side note this took me 12 12 years of my life 12 years of Blood Sweat tears and debt to achieve that so I'm very proud to say that I'm a board certified Derm and I'm going to say with every video that I do so that the billions of people who do not know me or do not know where they're getting their information from now know where they're getting their information from today we're going to talk about sagging skin not to fear-monger you about the aging process but to empower you so that you know what's going to come because it is inevitable and the reality is to to hopefully Open Your Arms Wide Open expecting it to come excitedly so because guess what the alternative is worse if you're not aging you're dead and I hope to God I can sag till my tits reach my toes all right that's maybe not so much maybe I'll do a little something for that story for another day the point of this video is to empower you with the tools at your disposal so that nobody not even a board certified dermatologist can pry on your insecurities or take you for a ride so with that being said if you're watching welcome you're probably 30 or 40 years old and you're like what's happening to my face and you're realizing that your face isn't quite what it used to be there are several peaks of life where we notice this and we also notice along those Peaks that our hair starts to thin I'm going to do a little quick Veer to the left and talk about hair thinning for a a hot second because it is related to the SAG it does happen simultaneously I'm nearly 40 years old I've had two babies and I've experienced really bad postpartum hair thinning and I just want to say thank you to nutriful for sponsoring this portion of the video video for the Skeptics out there I've used neutral long before they've ever sponsored me or approached me to sponsor me for portions of my video and I carry them in my office I am a fan of the neutral women's vegan line because these babies have helped my hair dramatically I have noticed changes between 1 and 3 months and it has helped really improve my hair growth and how long my hair has gotten I take four of them a day they are very manageable to take and they are biotin free they are low in vitamins a c d e and zinc as well as ashwagandha extract to help with hair thinning so back to sagging skin our favorite topic because everything in the beauty industry claims to have a miracle ingredient or silver bullet that's going to supposedly fix your sag the reality is you have to understand why you're sagging in order to know what's going to help you or not help you sagging is not a one-step approach there are three main things that contribute to sagging and we're going to give the couch analogy a couch is made up of a wooden frame feathers and fabric correct your face is made up of a bone structure which is like the wooden frame of the couch a lot of stuffing including muscles fat collagen and elastin right that's the stuffing of the couch and your skin which is like the fabric of the couch when you're thinking of sagging one two three of these things can all or none be affected we're going to start with the bone structure which is the structure of the couch the bone structure of your face as we get older our bone structure does not stay the same and the beauty industry never addresses the bone structure because they can't do anything for it and they don't talk about it because then you'll know that what you have going on is kind of unfixable in a sense as we get older our bone structure our eyes get thinner the orbital Rim starts to get wider this way the zygomatic Arch which is our cheekbone thins out and gets narrower in height our mandible our jawline also gets narrower and starts to recede so we become like a melting little finger and everything around our bone structure starts to fall again do not get depressed because if you get depressed there's no point it's inevitable that we should be honored to be able to go through some people will tell you get a implant which is a piece of metal or some other material which is put on top of your bone through surgery the reason I'm not a fan of facial implants for the most part all right for the most part is that facial implants are proportions that do not change meaning facial implants are tiny pieces of material that are put on your face at a certain point in time to match the proportions that you have at a certain point in time but you're putting those implants on top of a shifting base where you'll start to look weird over time because your jawline is receding but your implant is still wide and all of a sudden you look like your jawline is like this but you're like kind of flattening over here so it doesn't make sense to put a permanent structure on a non-permanent base is my point when it comes to implants certain types of fillers can help with the appearance of giving you structure and definition along your bone structure I am talking specifically about a filler known as radius and I am not sponsored by any of these companies radius is a calcium derivative it is a much firmer filler it is not made up of hyaluronic acid and you cannot break it up the same way you can break up hyaluronic acid you also do not metabolize it the same way as you metabolize hyaluronic acid in fact when you inject radias in your face especially along like your bone or your jawline when you take an x-ray you can actually see it because of the calcium but it can give you a firmer looking appearance to your face and the good news is it doesn't last forever in that sense because you don't want it to last forever and you want to grow with your face in order to give firmness or not in certain vectors or directions number two back to the couch analogy let's go back to the stuffing which is the feathers we have muscles we have fat we have collagen in our face once we get older the muscles thin out the fat starts to get depleted the fat pockets start to shrink our collagen gets thinner and that can also contribute to the SAG in this particular instance if you're sagging due to volume loss certain fillers can be helpful you have bios stimulatory fillers that can help regenerate your own collagen like Sculptra which is an injectable that we've had on the market since the early '90s it was created for people with HIV who lost all the fat in their face and were basically looking gaunt like they were sinking and we noticed that sculpture has a value ad for people who've lost volume in their face so if you are sagging because you've lost volume certain bios stimulatory fillers like Sculptra can be help helpful additionally if you do not want to get married to Sculptra because it is quite an investment in terms of time and money hyaluronic acid fillers can also be helpful now before you roll your eyes at me you say oh no everyone looks like a puffer fish with hyaluronic acid that is not true I have been treating myself twice a year at most every single year for the past 9 years and I don't think I look crazy I have not injected my lips I have not injected my under eyes where I usually focus is along the jawline because I've always had a weak jawline and I've always been a little bit sensitive about this so I really focus it up here and honestly I do not inject here I do not inject here tiny bit over here fillers are all dependent on the type of filler you're using and how you're injecting it hyaluronic acid fillers let's start with those come in different weights and come in different ways that they are cross-link you have hyaluronic acid fillers that are very thick and dense that can hold a lot of weight so if you are sagging because your volume has dropped hyaluronic acid fillers that are higher in weight can kind of give the appearance or the illusion of a lift one placed insert in vectors to change the proportion of your face over time those are things like voluma or even reslin Contour then you have hyaluronic acid fillers that are not so dense in in shape that can kind of act like the drywall to give curvatures to your face like regular resellin with lidocaine Some people prefer juvaderm I'm not not a fan of juviderm to be very honest with you because I think it diffuses and people are confusing that with filler migration and then you have very superficial very lightweight hyaluronic acids that can actually be placed more superficially so it doesn't give a blue shadowing to your face and those are things like Bello and most recently skin viiv in the US which is a hyaluronic acid booster I don't love the marketing around it if I'm being frank it is not hydrating your skin all it is doing is being placed superficially and being able to spread superficially so it can give a tautness a tautness appearance to your skin where it looks like your skin is hydrated but it's not actually hydrating your skin anyway that's a story for another day so there are different types of fillers that you can actually use to help with your volume and the third is if you have a lot of fat elsewhere you could do fat transfers fat transfers are a great thing but they're CA prohibitive and very honestly I've seen a lot of bad results when done very fast when you take fat from Elsewhere on your body and put it in other parts of your face fat needs to graft it needs to stick on average 30 to 40% of the fat that you take and you place sticks so 60 to 70% of the fat that you place doesn't stick we are not God we cannot predict how the fat sticks and so you have to do it very slowly and conservatively over time to get the best results cuz I've seen people look lopsided from the fat and how it actually Settles over time we also have threads threads are new again they were new in the early 2000s there were a lot of complications they went off the market they came back onto the market people went wild in 2019 where they would put thousands of threads in a person's face and then they kind of are going out of Vogue again but they shouldn't really be viewed that way because an extreme of anything can be bad polyl lactic acid or polydioxanone are the types of threads that we place underneath the skin to stimulate collagen they're like resolvable sutures so if somebody is really sagging in a certain way cuz a lot of weight is down here they just help to hold the weight and I tell my patients is this something I want to do every single time on your face answer is no especially if you want to one day get a face lift because ultimately you're creating firmer harder collagen that somewhat mimics scarring so if you want to get a facelift one day and you have a thousand threads in your face it's going to be harder for the surgeon to get through the different layers of your face in order to achieve a nice pull if you never want to get a facelift knock yourself out and so that is the discussions that you need to be having with your provider and last is the fabric of the couch the actual skin our skin changes over time and we lose elasticity because we emote because we smile because we cry because we go out in the sun because we smoke I've never actually smoked because we drink I have drank but the reality is life stress environment Sun emoting all affect the elasticity of your skin and just like your pants and the waistband gets looser over time if you grow in a certain direction your face gets looser over time too because you lose elasticity in your face and different options are also available on the market to help with elasticity we have ultrasound energy heat that can actually contract the mus muscles and tighten the skin that is also known as alera then we have radio frequency heat which is basically a Vari creation of a theme that is delivered to your skin without breaking the surface of your skin like Thermage but most recently Micron needling has come into Vogue married to radio frequency and Micron needling with radio frequency heat breaks the surface of your skin while delivering the heat underneath and those are treatments like Morpheus which you've probably heard of too much of any of these things is going to be bad because too much of any of these things can lead to Fat melting which we don't want to really do but just the right amount everything in moderation slight consistency over intensity and I say slight because every cosmetic procedure it needs to be done lightly unlike skincare you can knock yourself out but consistently right has to be done in moderation when it comes to procedures slight consistency over intensity over time can make a difference so these are all treatments that help to tighten whether radio frequency or ultrasound whether you micro needle married to radio frequency or not they're all variations of a theme and I kind of bucket them as such in terms of Micron needling alone without radio frequency that's just like causing blind trauma hoping that your body is going to regenerate itself over time you're basically causing tiny little wounds on the surface of your skin allowing your skin to heal in theory sounds right but you can exhaust your skin and that process in the meantime and if you're prone to rosacea or red skin it's probably not a great idea to Break Your Skin Barrier constantly three is microc coring which just came out there's a device known as elor and this looks barbaric if I'm being frank but we create tiny holes bigger than Micron needling right but smaller than big holes all over the surface of your skin it is a bloody treatment that basically is hoping that the skin then heals in and allows your skin to look tighter over time the holes are microscopic so you're not going to have holes all over your face but that is essentially what that treatment is doing everything great was once new not everything new is great my money is to wait on the on this treatment and to see how other people are doing there have been some scary side effects like scarring and chids that have formed but there have also been some good results so I'm just going to sit down sit by the you know bleachers and watch other people you know put themselves through it before I decide what I offer to my patients and it's not something that I offer yet and then you have PRP PRP also helps slightly with the volume but PRP is when we take your blood we spin it and you have the platelet rich plasma from your blood which is rich in growth factors the reason why I think PRP works not in everyone i' say probably 40% to 50% of patients you see a result with it is that it helps to really firm the collagen that's already present it's not making new tissue but for example with the under eyes right you have fat pads that bulge when you inject PRP there over time those fat pads develop a firmer capsule to them giving the illusion of firmness underneath your eyes I'm not adding more collagen to mask it and I'm not getting rid of the fat pads I'm just firming it up almost like spanks and that's sort of how I view PRP in the longer term process superficially it does give the appearance of firmer looking skin as well and because it has growth factors you can actually use it on your hair going back to the original part of the video and help with hair growth that's a side note and then you have Peels and lasers which can also help with a superficial aspect of your skin as well like fra a which can help in the long run stimulate collagen and chemical peels but you need to have deeper peels like phenol peels or TCA peels to stimulate more collagen and they have more downtime and more risk and last skin care things that you can do at home if you cannot afford to go into the office or you have no desire to go into the office skinc care can be a powerful tool but it's never going to address all three of these issues no skin care is ever going to replenish volume get that out of your heads and once you have that out of your heads you will be happier but skin care can help give the appearance of firmer looking skin and smoother looking skin so those are where retinols come in certain types of peptides come in I'm going to link a bunch of videos that we've covered this in because it would take too long and I probably already lost half of You by this by minute 16 of a video but skinc care can really be a powerful tool when used consistently over time and with skincare it's about consistency over intensity because it's a long-term game that you're playing you can also have other at home devices like microcurrent devices like the new face the new face is great only as long as you use it it's been sitting by my bed stand for years so it has not been great for me but microcurrent can generate ATP in your cells which can help boost collagen and elastin in the longer run but it's just annoying to do it's like going to the gym it's like another routine that I don't have time for and then you have led devices like red light LED that has anti-inflammatory benefits over time but again you have to do it a lot very consistently to really see a difference in the long run and not all LED devices are created equal so anyway I hope you guys enjoyed this video it is a very comprehensive video and the reason I thought it was important for you guys to really have an understanding is so many of my patients come in not knowing what they've had done at other offices and that like kills my soul because I'm like you you could have or you were taken for a ride and it's not fair to you your pocket your hard-earned cash or your face quite frankly so anyway I hope you guys enjoyed this video wishing you a beautiful Saturday I hope you guys feel empowered and not unmotivated and if you have any questions let me know below and I will try to create short format videos to help you guys navigate this process have a great [Music] day

Channel: Dr. Shereene Idriss

Views: 508,909

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Id: 4csJ1gVXSv8

Length: 17min 51sec (1071 seconds)

Published: Sat Nov 11 2023