Hope Merz, DNP performs a typical facial consultation on a 24 year year old who is preparing for her wedding day in a few weeks.

Hi, everyone. Hope Merz, Nurse Practitioner at the Advanced Cosmetic Surgery and Laser Center. Today we are talking with Clare Lynch. We are going over kind of what she's starting to see in the mirror with the aging process. She's young. She's twenty four. She's actually getting ready to get married. So we're going to have kind of a short term plan, a long term plan, and I'll kind of go over with her what to look for and what we're treating in certain areas and with what kind of product.

So first of all, there's a few reasons, a few main reasons that we see what we see when we look in the mirror. Number one is our skin. So over the years, our skin starts to thin, we lose collagen, we lose elasticity and it can crease easier and it can fall easier. So we want to make sure to do certain things like good medical grade products at home. We want to do microneedling, chemical peels, dermaplanes, different maintenance procedures for our skin.

If your skin has had some years of damage, we may need to do a little bit of reversal for damage, such as the DOT laser. And more aggressive treatments that come with a little bit more downtime. But for someone like Claire, we'll probably plan a routine at home of skin care products and then maybe some chemical peels mixed with dermaplans in her 20s. So number two is our muscle movements. OK, so Claire, why don't you make a frown? So this is what we call the glabellar complex.

That muscle pulls downward. So what it starts to create are these elevens we call them eleven's in between the brow. Some people get a one. It's just one crease right in the middle. Some people get three of them one one one. And those creases start becoming more and more deep over the years. So that's what we're going to actually treat with Botox today. So Botox is very common for this muscle group. And then go ahead and raise your forehead up for me. So the frontalis muscle is this big muscle that comes from the brow up to the scalp, and that is what creates these horizontal lines.

So we're also going to use Botox to help treat that muscle group. Now, the Botox isn't actually doing anything to help the skin integrity, so we still want to make sure we do our skin care products and procedures. But the muscle is going to stop moving here or it's going to slow down so that we can't crease it. Hence, the creases fallout over a few weeks. It doesn't look like you have these much yet, but go ahead and smile for me. So this is a third group that's really popular muscle group to treat. This is our crow's feet area, and we typically will do Botox here too as needed, but it doesn't look like Claire's really pulling there yet.

So later on a few years, you have with that still. Great.

All right. I just saw a little bit of a bunny line here. So these are popular too. Those are from smiling and scrunching our nose up so we can actually treat that with Botox as well. The third thing that we're going to notice is our volume loss. So we lose not only the thickness from the skin, but also muscle, fat, bone all starts to degrade over the years, and we start to lose this beautiful contour that we have in our twenties with our cheekbones and our jawline and our chin and all of that. So Claire doesn't really need much in those areas yet, but we may think about maybe replacing a little bit of volume with some filler and some shadowy areas we're seeing here.

Maybe a touch under the eye eventually, but that's usually what filler treats.

So today we'll do some Botox. We'll get a good skin care plan going, and then we'll kind of plan on others in the future as we need it.

So when you see her lower lip here and we have just like these little lines that almost look a little chapped, a little dehydrated, the Volbella is really going to help just kind of fill those in and provide for more hydrated appearance. It's not going to look like a lip augmentation, but we can put more and more product to be kind of what you prefer if you like a larger lip. If someone comes in and they say, I want bigger lips, I want my friends to notice, I want that full look. I tend to go more towards the Juvederm Ultra.

Juvederm Ultra grabs more water to it. So fillers kind of like a sponge. All of them bring a little bit of water to them as they settle into wherever we place them. Juvederm Ultra brings more, so that's our plumper. So for Claire, we'd probably start with a little Volbella.

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