Online chat with Dr. Vince Afsahi, Sept....
 
11:57
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Wednesday September 16, 2009 11:57 
11:57
Colin Stewart: 

Welcome to "In Your Face CHAT."   I'm Colin Stewart of the cosmetic-medicine blog "In Your Face."

 

 

Our guest today is

dermatologist Dr. Vince Afsahi  of Tustin and Newport Beach.

 

Welcome, Dr. Afsahi.

Wednesday September 16, 2009 11:57 Colin Stewart
11:57
Wednesday September 16, 2009 11:57 
11:58
Dr. Vince Afsahi: 
Thank you . Good to be here.
Wednesday September 16, 2009 11:58 Dr. Vince Afsahi
11:58
Colin Stewart: 

Our topics for this chat are (1) Pamela Anderson and sunscreen, (2) celluite, (3) injectable dermal fillers, and (4) dermal rollers, which Angelina Jolie supposedly uses to keep her skin young-looking.

 

But I'll make sure that we leave time for readers' questions, even if that means we can't get to all those topics.

 

 

I'm ready for readers to start submitting questions about sunscreen, cellulite and skin-care in general.

Wednesday September 16, 2009 11:58 Colin Stewart
11:58
Colin Stewart: 

I'm going to start things off with questions about Pamela Anderson and sun damage. The former "Baywatch" actress recently told an interviewer that she doesn't use sunscreen. What's the going to do to her skin?   She's still a beach lover.

Wednesday September 16, 2009 11:58 Colin Stewart
11:58
Colin Stewart: 

She didn't actually say that she has NEVER used sunscreen, but she implied that she hasn't used it for a while.

I have a few recent closeup photos of her that can show you how her skin is faring.

Wednesday September 16, 2009 11:58 Colin Stewart
11:59
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Wednesday September 16, 2009 11:59 
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Wednesday September 16, 2009 11:59 
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Wednesday September 16, 2009 11:59 
12:00
Colin Stewart: 
Those photos can be enlarged by clicking on the magnifying glass symbol, by the way.
Wednesday September 16, 2009 12:00 Colin Stewart
12:00
Dr. Vince Afsahi: 
The sun is certainly taking its toll.. Brown spots, creases, all preamaturely from sun damage..
Wednesday September 16, 2009 12:00 Dr. Vince Afsahi
12:00
Colin Stewart: 
Is that prematurely aged skin?
Wednesday September 16, 2009 12:00 Colin Stewart
12:01
[Comment From Greg PerkinsGreg Perkins: ] 
Yikes... how would you treat pam's face? Can you reverse sun damage?
Wednesday September 16, 2009 12:01 Greg Perkins
12:01
Dr. Vince Afsahi: 
She takes great care of the rest of her body, but her skin is showing the effects. This is largely preventable
Wednesday September 16, 2009 12:01 Dr. Vince Afsahi
12:01
[Comment From samantha g.samantha g.: ] 
is there a way to get rid of the sun damages?
Wednesday September 16, 2009 12:01 samantha g.
12:02
Dr. Vince Afsahi: 
Its not too late to help. Sun protection is vital. We can help with the dark spots with lighting serums and perhaps intense pulsed light devices
Wednesday September 16, 2009 12:02 Dr. Vince Afsahi
12:03
[Comment From KelleyKelley: ] 
What can be used to treat the forehead lines besides Botox? (I have terrible allergies and I am a vegetarian)
Wednesday September 16, 2009 12:03 Kelley
12:03
Dr. Vince Afsahi: 
Good question about the lines
Wednesday September 16, 2009 12:03 Dr. Vince Afsahi
12:03
Colin Stewart: 

She didn't say why she doesn't use sunscreen. For most people who don't use it, it's because it's a bother.

Wednesday September 16, 2009 12:03 Colin Stewart
12:03
Colin Stewart: 

Pamela Anderson seems to associate applying sunscreen with behaving unnaturally. In that interview, she said, "I don't have a skin-care program. I have no dermatologist and no cosmetic surgeon. Nothing's been shot into this face."

Wednesday September 16, 2009 12:03 Colin Stewart
12:03
[Comment From Greg PerkinsGreg Perkins: ] 
Is there a way to get rid of the wrinkles?
Wednesday September 16, 2009 12:03 Greg Perkins
12:04
Colin Stewart: 

RE: Pamela Anderson seems to associate applying sunscreen with behaving unnaturally. In that interview, she said, "I don't have a skin-care program. I have no dermatologist and no cosmetic surgeon. Nothing's been shot into this face."

 

That's a surprising line of thinking for someone who has repeatedly swapped implants in and out of her breasts.

Wednesday September 16, 2009 12:04 Colin Stewart
12:04
Dr. Vince Afsahi: 
Lines and creases can be softened with fractional based lasers with or without Botox
Wednesday September 16, 2009 12:04 Dr. Vince Afsahi
12:04
[Comment From samantha g.samantha g.: ] 
she needs a derm! hah
Wednesday September 16, 2009 12:04 samantha g.
12:06
Dr. Vince Afsahi: 
Intersting. She is at high risk for skin cancer, because of her fair skin and light eyes. I would rec her to see a dermatologist for prevention.
Wednesday September 16, 2009 12:06 Dr. Vince Afsahi
12:06
Colin Stewart: 
How do you expect Pamela Anderson will look if she continues as she's going now?
Wednesday September 16, 2009 12:06 Colin Stewart
12:07
Dr. Vince Afsahi: 
Beach goers with fair skin age very fast. Collagen is destroyed, and she may look age beyond her years
Wednesday September 16, 2009 12:07 Dr. Vince Afsahi
12:07
Dr. Vince Afsahi: 
More importantly is her risk of skin cancer, which we are seeing in younger and younger patients.
Wednesday September 16, 2009 12:07 Dr. Vince Afsahi
12:07
[Comment From SarahSarah: ] 
Are the lasers a long term solution? Or is Botox better?
Wednesday September 16, 2009 12:07 Sarah
12:09
Dr. Vince Afsahi: 
Long term solutions are usuallly tailored to the patient. Botox softens the muscle movement, lasers help with the areas with or without Botox. Therefore they can be used together for long term results
Wednesday September 16, 2009 12:09 Dr. Vince Afsahi
12:10
Colin Stewart: 
And Botox is only long-term in the sense that you have to keep getting injected repeatedly to keep seeing the results.
Wednesday September 16, 2009 12:10 Colin Stewart
12:10
[Comment From samantha g.samantha g.: ] 
i think she has had a face lift at some point
Wednesday September 16, 2009 12:10 samantha g.
12:11
Dr. Vince Afsahi: 
Botox does require contnued injections, sometimes 3 to 4 times a year
Wednesday September 16, 2009 12:11 Dr. Vince Afsahi
12:11
[Comment From Greg PerkinsGreg Perkins: ] 
That can get pricey...
Wednesday September 16, 2009 12:11 Greg Perkins
12:12
Colin Stewart: 
Here's another question from a reader that's related to sun protection:
Wednesday September 16, 2009 12:12 Colin Stewart
12:12
[Comment From SarahSarah: ] 
Is there a real difference between SPF 85 and 30? What should we be using in light of global warming?
Wednesday September 16, 2009 12:12 Sarah
12:13
Dr. Vince Afsahi: 
The best sunscreens are those that are physical blockers, block all spectrums of UV. The difference between a 30 and 85 is minimal....
Wednesday September 16, 2009 12:13 Dr. Vince Afsahi
12:14
Dr. Vince Afsahi: 
Sunblock should be reapplied every 2 hours, when outside. so pick one that you are going to be comfortable using. Zinc or Titanium dioxide products are superior
Wednesday September 16, 2009 12:14 Dr. Vince Afsahi
12:14
[Comment From SarahSarah: ] 
Is there a particular brand I should buy? Is it different for my children vs. myself and my husband?
Wednesday September 16, 2009 12:14 Sarah
12:16
Dr. Vince Afsahi: 
Body location is really a determining factor. Lighter sunblocks are usually reserved for the face, while the body is thicker
Wednesday September 16, 2009 12:16 Dr. Vince Afsahi
12:17
Dr. Vince Afsahi: 
The ingredients are usually the same, so look for the complete physical blocker, without fragrances or dyes to limit irritation
Wednesday September 16, 2009 12:17 Dr. Vince Afsahi
12:18
Colin Stewart: 
FYI. In a previous chat and in a guest post for the "In Your Face" blog, dermatologist Dr. Renee Cobos of Fullerton had a lot of advice about sunscreens, including a link to a Web site with lots of ratings and analysis of different brands. Her guest post is at this Internet address: http://inyourface.freedomblogging.com/2009/07/01/sunscreen-the-world%e2%80%99s-best-beauty-product/7455/
Wednesday September 16, 2009 12:18 Colin Stewart
12:18
Dr. Vince Afsahi: 
Many patients like the Neutrogena products or Sol bar
Wednesday September 16, 2009 12:18 Dr. Vince Afsahi
12:19
Colin Stewart: 
sunscreen
Wednesday September 16, 2009 12:19 Colin Stewart
12:19
Dr. Vince Afsahi: 
The best sunblock is the one you are actually going to use!
Wednesday September 16, 2009 12:19 Dr. Vince Afsahi
12:20
Colin Stewart: 
I think that was one that I found that met the critieria that Dr. Cobos and the Web site recommended. The search was long. Lots didn't meet the criteria.
Wednesday September 16, 2009 12:20 Colin Stewart
12:20
[Comment From SarahSarah: ] 
Those are great tips, I will try those and look for complete coverage as well...
Wednesday September 16, 2009 12:20 Sarah
12:20
Colin Stewart: 
OK. Now I'm ready to turn to our next topic, but first several questions from readers.
Wednesday September 16, 2009 12:20 Colin Stewart
12:21
[Comment From KelleyKelley: ] 
Hi Dr Afsahi. Can you tell me if anything works to reduce the appearance of dark circles under the eyes?
Wednesday September 16, 2009 12:21 Kelley
12:22
Dr. Vince Afsahi: 
Difficult. No perfect treatment here. Usually genetic. Retinoid creams and vitamin K creams have been used . Lasers and IPL devices have been used with mild success. A combination of both may be tried
Wednesday September 16, 2009 12:22 Dr. Vince Afsahi
12:23
Colin Stewart: 
Another reader question:
Wednesday September 16, 2009 12:23 Colin Stewart
12:23
[Comment From KelleyKelley: ] 
I use Restylane for lips and nasal folds. Are there any injectables (non allergic) that would work? Are fractional laser treatments expensive?
Wednesday September 16, 2009 12:23 Kelley
12:25
Dr. Vince Afsahi: 
The most common filler for those areas are hyaluronic acids. I do like Restylane and Juvederm . They are both non animal based products
Wednesday September 16, 2009 12:25 Dr. Vince Afsahi
12:25
Colin Stewart: 
Hey, Kelley.   Was that a question about Pamela Anderson?
Wednesday September 16, 2009 12:25 Colin Stewart
12:26
[Comment From ColtonColton: ] 
what about youthology?
Wednesday September 16, 2009 12:26 Colton
12:27
Colin Stewart: 
Hi, Colton. You'll have to provide me and Dr. Afsahi more info about that question. We don't know about Youthology.
Wednesday September 16, 2009 12:27 Colin Stewart
12:27
Dr. Vince Afsahi: 
Fractional Lasers are now becoming more resasonable. Depends on what problems are being treated, and how many sessions you need. Usually $800+ per treatment. So a consult would be worth it before signing up
Wednesday September 16, 2009 12:27 Dr. Vince Afsahi
12:28
Colin Stewart: 
Here's Kelley's response about the context of her question. She was asking whether injectables or lasers would work for Pamela Anderson.
Wednesday September 16, 2009 12:28 Colin Stewart
12:28
[Comment From KelleyKelley: ] 
Yes, it was about the fine lines on her forehead
Wednesday September 16, 2009 12:28 Kelley
12:29
Dr. Vince Afsahi: 
Fine lines can be treated with fractional lasers with or without Botox. Botox is the most economical way
Wednesday September 16, 2009 12:29 Dr. Vince Afsahi
12:29
Colin Stewart: 
Here's a reader question that shifts us over to planned Topic 2: cellulite.
Wednesday September 16, 2009 12:29 Colin Stewart
12:29
[Comment From Faith19Faith19: ] 
How do the cellulite treatments work? I have a lot of friends doing it and they look great.
Wednesday September 16, 2009 12:29 Faith19
12:31
Colin Stewart: 
Back on Youthology, before we move on to cellulite, here's Colton's reply:
Wednesday September 16, 2009 12:31 Colin Stewart
12:31
[Comment From ColtonColton: ] 
saw it on an infomercial.. 90-second wrinkle-remover.
Wednesday September 16, 2009 12:31 Colton
12:31
Colin Stewart: 
We'll have to watch for it. Thanks.
Wednesday September 16, 2009 12:31 Colin Stewart
12:31
Colin Stewart: 
Back to cellulite:
Wednesday September 16, 2009 12:31 Colin Stewart
12:31
Dr. Vince Afsahi: 
The most common cellultie treatment in our office is Velashape. It uses suction, radiofrequency energy and light energy to heat the adipose tissue and increase lymphatic drainage.
Wednesday September 16, 2009 12:31 Dr. Vince Afsahi
12:33
Dr. Vince Afsahi: 
Remember: diet and exercise are important too. Fortunately, however, technology has allowed improvement with this very difficult problem.
Wednesday September 16, 2009 12:33 Dr. Vince Afsahi
12:33
Colin Stewart: 
Faith19, you and Dr. Afsahi report greater satisfaction from cellulite patients than I typically hear of. For example, on the Realself.com Web site, only 35 percent of patients said they were satisfied with the results of their cellulite treatments.
Wednesday September 16, 2009 12:33 Colin Stewart
12:33
Colin Stewart: 
(The exact treatment isn't specified there.)
Wednesday September 16, 2009 12:33 Colin Stewart
12:34
Colin Stewart: 

In general, says plastic surgeon Dr. Steven Dayan, 85 percent patients getting cosmetic treatments in clinical trials report being satisfied with the results – even when NOTHING was done to them.   So I'm very skeptical of a 35% rating.

Wednesday September 16, 2009 12:34 Colin Stewart
12:34
[Comment From samantha g.samantha g.: ] 
i saw that... my friend tried it and it turned her face red for a week! stay away from it!
Wednesday September 16, 2009 12:34 samantha g.
12:35
Colin Stewart: 
Samantha -- that's Youthology, right?
Wednesday September 16, 2009 12:35 Colin Stewart
12:35
[Comment From samantha g.samantha g.: ] 
youthology is a scam
Wednesday September 16, 2009 12:35 samantha g.
12:35
[Comment From samantha g.samantha g.: ] 
yes!
Wednesday September 16, 2009 12:35 samantha g.
12:35
Dr. Vince Afsahi: 
Its a diifficult problem. No doubt. Usually the better results are those who are active and healthy.
Wednesday September 16, 2009 12:35 Dr. Vince Afsahi
12:35
[Comment From NicoleNicole: ] 
Do any kinds of topical creams work for cellulite at all?
Wednesday September 16, 2009 12:35 Nicole
12:36
Colin Stewart: 

Dr. Christopher Zachary, chairman of the UCI Department of Dermatology, says cellulite isn’t a medical condition — it’s a secondary female sex characteristic like breasts and wide hips.

Wednesday September 16, 2009 12:36 Colin Stewart
12:37
Dr. Vince Afsahi: 
Creams are usually of limited use. There have been caffeine-based or antioxidant-based which have been studied. No miracle just yet.
Wednesday September 16, 2009 12:37 Dr. Vince Afsahi
12:37
Colin Stewart: 

I've often quoted dermatologist Ava Chambon of Santa Monica on the subject of cellulite. She says cellulite is “Public Enemy No. 1” for many women. But she adds about cellulite treatments:

" 'This device will get rid of your cellulite' is one of the world’s top lies, close behind 'I’ll respect you in the morning.' "

Wednesday September 16, 2009 12:37 Colin Stewart
12:37
Colin Stewart: 
More reader questions next, on a variety of topics.
Wednesday September 16, 2009 12:37 Colin Stewart
12:38
[Comment From tonymtonym: ] 
Is laser hair removal permanent?
Wednesday September 16, 2009 12:38 tonym
12:39
Dr. Vince Afsahi: 
A permanent reduction is likely. But strong genetics can result in patchy regrowth. But the results can be excellent
Wednesday September 16, 2009 12:39 Dr. Vince Afsahi
12:39
Colin Stewart: 
Often that's after several sessions, right?
Wednesday September 16, 2009 12:39 Colin Stewart
12:39
Dr. Vince Afsahi: 
The best candidates have light skin and dark hair. Usually more than five sessions are needed
Wednesday September 16, 2009 12:39 Dr. Vince Afsahi
12:40
Colin Stewart: 
Next, two risk-related questions from readers:
Wednesday September 16, 2009 12:40 Colin Stewart
12:40
[Comment From LendaLenda: ] 
Is the laser radiation from lasers something to be concerned about be exposed to?
Wednesday September 16, 2009 12:40 Lenda
12:40
[Comment From KelleyKelley: ] 
What are the risks associated with Velashape? similiar to lipo?
Wednesday September 16, 2009 12:40 Kelley
12:41
Dr. Vince Afsahi: 
Laser based treatments are usually very safe, if you are the right candidate , and you are in experienced hands.
Wednesday September 16, 2009 12:41 Dr. Vince Afsahi
12:43
Dr. Vince Afsahi: 
Velashape is non-invasive, not liposuction. There is no surgery involved. Most common side effects are redness and bruising. Mostly, a very comfortable procedure
Wednesday September 16, 2009 12:43 Dr. Vince Afsahi
12:44
Colin Stewart: 
Lenda, I want to reinforce Dr. Afsahi's comment about making sure you're in experienced hands. It's important to check the doctor's qualifications.   Here's a post, "15 ways to spot a bad doctor."   (at this Web address)
http://inyourface.freedomblogging.com/2009/09/02/15-ways-to-spot-a-bad-doctor/9787/
Wednesday September 16, 2009 12:44 Colin Stewart
12:45
Colin Stewart: 
Many cosmetic doctors tell me of patients coming to them damaged by others.
Wednesday September 16, 2009 12:45 Colin Stewart
12:45
[Comment From NicoleNicole: ] 
Whats the price range for Velashape?
Wednesday September 16, 2009 12:45 Nicole
12:46
Dr. Vince Afsahi: 
Velashape runs about $200-250 per area per session. Usually 4-6 sessions are recommended.
Wednesday September 16, 2009 12:46 Dr. Vince Afsahi
12:47
[Comment From Greg PerkinsGreg Perkins: ] 
With the death of Kanye West's mom, amongst others, liposuction seems like too great a risk unless you are severly obese.
Wednesday September 16, 2009 12:47 Greg Perkins
12:48
Dr. Vince Afsahi: 
Many patients prefer the noninvasive approach to cosmetic issues
Wednesday September 16, 2009 12:48 Dr. Vince Afsahi
12:48
[Comment From KelleyKelley: ] 
Are there products or treatments that stimulate collagen production?
Wednesday September 16, 2009 12:48 Kelley
12:49
Dr. Vince Afsahi: 
Topical treatments include the retinoids, like retinol and retin A. Laser treatments can heat and stimulate collagen contraction and reorganization as well. We treat patients using both modalities
Wednesday September 16, 2009 12:49 Dr. Vince Afsahi
12:49
[Comment From KelleyKelley: ] 
Is it better to go to a Dermatologist or Plastic Surgeon for injectables?
Wednesday September 16, 2009 12:49 Kelley
12:50
[Comment From KelleyKelley: ] 
Is it safe to use Retin A under the eye?
Wednesday September 16, 2009 12:50 Kelley
12:51
Dr. Vince Afsahi: 
I am a dermatologist and feel very comfortable with the training we receive. In fact dermatologists pioneer many of the procedures that are nonsurgical. You must go to someone with experience either plastics or derm.
Wednesday September 16, 2009 12:51 Dr. Vince Afsahi
12:51
[Comment From NicoleNicole: ] 
For a 24 year old woman on a limited budget, what would you suggest for skin care for extremely fair skin? Do you think it's necessary to start using anti-wrinkle creams at night?
Wednesday September 16, 2009 12:51 Nicole
12:52
Dr. Vince Afsahi: 
Sunblock in the morning. And a retinoid at night time. Most bang for the buck.
Wednesday September 16, 2009 12:52 Dr. Vince Afsahi
12:53
Dr. Vince Afsahi: 
Litttle things like a nice routine will prevent a lot of future procedures and can save you money
Wednesday September 16, 2009 12:53 Dr. Vince Afsahi
12:53
[Comment From ToddTodd: ] 
I'm wondering about laser scar removal. How effective is it?
Wednesday September 16, 2009 12:53 Todd
12:54
[Comment From Stefany Stefany : ] 
I had a question about small acne scars, litlle pockmarks. Anything that will help with those besides laser? Any kind of products I can use?
Wednesday September 16, 2009 12:54 Stefany
12:54
Dr. Vince Afsahi: 
The fractional lasers are showing more and more efficacy for acne scars and for scars in general. Very optimistic
Wednesday September 16, 2009 12:54 Dr. Vince Afsahi
12:55
Colin Stewart: 
This is for small acne scars, or also for big scars like a pirate might have?
Wednesday September 16, 2009 12:55 Colin Stewart
12:55
Dr. Vince Afsahi: 
Small Acne scars can be treated with either excision, or filling them in . Depends on the type of scare
Wednesday September 16, 2009 12:55 Dr. Vince Afsahi
12:56
Dr. Vince Afsahi: 
A custumized approach is good for scars, topical plus procedures are used
Wednesday September 16, 2009 12:56 Dr. Vince Afsahi
12:57
Dr. Vince Afsahi: 
Big scars can be excised or more aggessive fractional treatments can be used.
Wednesday September 16, 2009 12:57 Dr. Vince Afsahi
12:57
Colin Stewart: 
Wow. I see that we're out of time. Thanks, readers, for lots of good questions. I'm sorry we didn't get to all o them. And thanks for joining us, Dr. Afsahi. Let's do this again sometime.
Wednesday September 16, 2009 12:57 Colin Stewart
12:58
Dr. Vince Afsahi: 
Thank you. A great discussion. See you soon.
Wednesday September 16, 2009 12:58 Dr. Vince Afsahi
12:58
Colin Stewart: 

Here's the link to our schedule of upcoming guests.

Wednesday September 16, 2009 12:58 Colin Stewart
12:58
Colin Stewart: 
Schedule of upcoming 'In Your Face CHATs'
Wednesday September 16, 2009 12:58 Colin Stewart
12:58
Colin Stewart: 

The next guest for an "In Your Face CHAT" will be bariatric surgeon Dr. Brian Quebbemann of Newport Beach. He will discuss weight loss programs, liposuction and the various forms of bariatric surgery.

Wednesday September 16, 2009 12:58 Colin Stewart
12:58
 

 
 
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