My skin and facial muscles are starting to sag. I am 39 years old and don’t want a surgical face lift. What are the alternatives?

Non-surgical lifts using specialized electrical equipment are now being offered at many skin and beauty care salons as well through other professionals such as some chiropractors and massage therapists.

Unlike the rest of the body, the facial muscles attach directly into the skin to allow facial expression. Thus when the muscles begin to lose tone with age, the skin will sag with them. The skin also loses tone with the breakdown of the elastic fibres of the tissues. The basic principle of most face-lift machines is to stimulate the facial muscles, increase their tone, thereby lifting the tissues to which the muscles are attached. These machines vary in the type of current used and whether they are placed on the motor points of the muscles or the acupuncture points in stimulating the contractions. The face will be “lifted” but the elasticity of the skin itself will be the same as before. It is therefore wise to accompany the procedure with facial treatments to improve the condition of the dermis and epidermis (the main layers of the skin).

A new technique involves the electrical stimulation of the muscles along with a laser stimulation of the “fibroblasts.” These structures manufacture connective tissue, including collagen, a structural protein found in the skin. With this type of treatment, then, the condition of the skin is improved as well as the muscle tone.

Generally a person will require 10-12 treatments given within a short span of time, e.g. four to six weeks. Home care products and maintenance treatments may be recommended. The effects could last eight months to two years depending on the age and health of the individual, the type of machine used and home care.

The advantage of non-surgical over surgical lifts is that there is no scarring or bruising, they are painless and do not require you to take any time away for a healing process. The change in facial appearance is gradual so it is not suddenly noticeable that you have had a lift. Prices vary widely but may be approximately $3000-$15000 for the series. (Surgical lifts vary as well but are often around $6,500.) However some of the non-surgical treatments may not last as long as the surgical procedures. Also, there is sometimes excess tissue associated with sagging skin which the surgeon can remove. Your choice of procedure should take into account the condition of the skin, the results you want to achieve and the amount of time and money you are willing to invest.

I have bad breath much of the time. My doctor has checked me and says that I’m fine and my dentist confirms that my oral hygiene is good. Could the problem be related to my allergies?

Allergies such as rhinitis (hay fever) or sinusitis can be a cause of bad breath. When the nasal passages are plugged, people naturally have to breathe through their mouth thus reducing the amount of saliva in the mouth. This makes it more difficult to get rid of the debris that can cause a bad odor. Mouthwash will only mask the prolem temporarily.

Other causes could include alcohol, smoking, garlic, onions, tooth decay, plaque, gum problems, etc.

Sometimes a breath odor will develop when you are not eating regular meals e.g. at the end of a long work day. The degree of odor will depend on what you last ate. Chronic bowel irritation can also lead to this problem. This could be constipation, diarrhea, gas, pain, ulcers. Stress can be a problem as it impairs bowel function. Digestive disturbances can also result from foods that you have difficulty in digesting, e.g. those that cause you “heartburn” or cause a nauseous feeling.

An over all toxic condition of the system will give rise to breath odor. This would be accompanied by other symptoms such as excessive perspiration, body odor, sweaty feet.

Other causes include cancer, drug reactions and mental health problems such as depression.

I have read in a U.S. magazine that the two most common types of dilated veins are spider angiomas and simple telangiecstasis which may appear on the face, neck, hands or legs. The best treatment currently available involves a small electric needle or electrosurgical tip. An electric current is shot through the skin to the central vessel or capillary which collapses and becomes invisible to the eye. My question is if this treatment is available in Canada and who administers it.

The type of procedure you describe is performed in Ontario by dermatologists. Ask your doctor for a referral. Another newer type of treatment for these conditions involves the injection of a sclerosing medication into the affected vessel causing it to harden and disintegrate. This procedure is done only by specialists in Toronto and Montreal.

I am using the pigmentation fading creams on my face. I have used it for about four weeks and still don’t see good results. What am I doing wrong?

The over-the-counter fading creams must be applied at least twice a day on the face (or more often on the hands because they are in water etc.) and on the spots only. Do not apply it all over the face – then all the facial skin will also be lightened too. The skin should gradually lighten in about six to eight weeks. If it doesn’t, we suggest seeing a skin specialist as it might not be a pigmentation disorder.

We also suggest using a sunscreen with a SPF factor of minimum 15 and higher on the areas especially affected with pigmentary marks; and minimize sun exposure, winter as well as summer.