Younger Every Day?

Anti-Aging Management

An Interview with Dr. Dean Kane
by: Wanda Minnis-Dyson, MD

Dr. Dean P. Kane, MD, FACS, PA is a plastic surgeon who heads up the Center for Anti-Aging Medicine and Cosmetic Surgery in Baltimore . Dr. Kane is Board Certified by the American College of Surgeons, certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons, Certified by the American Board of Anti-Aging Medicine, and a diplomate of the National Board of Medical Examiners. He has co-authored Chronic Wound Care: A Clinical Source Book for Health Care Professionals.

Dr. Dyson: As a plastic surgeon, I find it interesting that your practice includes so many non-surgical cosmetic procedures. Why do you think less invasive procedures will dominate in the future?

Dr. Kane: Less invasive procedures are now becoming more effective and longer lasting. I do not anticipate invasive procedures to ever go away unless we truly reverse aging but I do believe that the earlier we begin to add nutrients, anti-oxidize, internally "moisturize" our tissues and stall the degenerative effects of aging, the longer we will delay the inevitable surgical procedures.

Dr. Dyson: Many of your patients have been seen in your center for many years. I was amazed by the before and after pictures of your patients. They actually look younger and better as they get older. How did you achieve those results?

Dr. Kane: Many patients have taken our recommendations to heart. They look in the mirror and don't like what they see. There is a disconnect between the physical effects of aging and how they feel emotionally. We all feel better when we look better and scientifically this vicious cycle is found to translate into less stress and less catabolic hormone production such as cortisol and catecholamine production.

We promote 3 fundamental and interactive spheres of "anti-aging" management:

Protection, nutrition, reversal.

• Protection with sun block and internal and external anti-oxidants.
• Nutrition using a low carb, low fat, well hydrated diet with low calories and plenty of nutrients, essential fatty acids, minerals and vitamins.
• Reversal involves many actions. Retin A and hydroquinone as practiced in the Obagi Skin Health and Restoration program provide the standard of care in reversing skin aging by targeting the cell and DNA with increasing turnover of cells and regulating cell function and pigmentation.

Botox, Restylane and chemical peels reduce the muscle hyperactivity, lines and tighten the skin augmenting the effects above.

Reduction of stress with complementary facial massages and microdermabrasions significantly help as well.

Dr. Dyson: What type of collateral damage to the skin may result from surgical procedures and how can it be prevented or minimized with the use of complimentary rejuvenation techniques such as glycolic acid and Retin-A?

Dr. Kane: Any injury to the skin in the form of surgery, laser, chemical or abrasive peels, heat, UV exposure, etc will cause inflammation and free radical formation. The free radicals injure the cell membrane, cell proteins and RNA and DNA directly cause ineffective building blocks or mutations. Inflammation is a prolonged reaction, which is useful in building collagen in the dermis of the skin, and effectively tightening the skin but it takes 3 weeks to 2 years to gain and eventually lose its effect. Therefore, in order to "anti-age" we have to consciously anti....age. Everyday we ag,e so every day we need to take the steps to stall or delay or reverse the effects of aging. Many of the degenerative diseases of aging are being tackled slowly. Ultimately the genome project will uncover the secrets behind the aging process. I believe that in 10 years we will effectively begin to reverse many of the physiologic effects of aging. As a global society, the cost of medical care is now becoming too expensive. We must learn to delay these degenerative processes.

Glycolic acid has properties that penetrate the top layer of the epidermis superficially to separate the stratum corneum and lift the roughness off. These peels plateau quickly and lose their performance.

Retin-A , a stronger acid (unlike retinol, retinaldehyde and others) penetrates the epidermis and dermis to affect the cell directly as it is a vitamin A derivative. It also directly affects DNA as we discussed above so it has two very powerful actions.

Dr. Dyson: I noticed that you perform a lot of Botox procedures for wrinkles, crow's feet, brow lift etc. Are you satisfied with the results and in which instances do you prefer Botox to a surgical procedure?

Dr. Kane: The effects of botox-A are phenomenal! A single 10-minute procedure for the fraction of the cost and none of the surgical risks are able to rebalance facial expression by weakening specific muscles-- if used correctly. I am able to raise brows, reduce scowl lines, and reduce forehead furrows, crow's feet and most lipstick lines with botox-A. I can lift the corners of the mouth, get a gentle lift of the jowl and reduce the necklines and bands.

Previously, most of these procedures needed surgery or could not be performed. There are limits though. When the skin slides beyond the ability of the underlying muscle to lift it, a surgical procedure will be necessary. So, botox-A is terrific in younger patients trying to rebalance facial expressions before permanent lines set in.

Dr. Dyson: In which cases do you prefer the use of Restylane to Botox or do you on occasion use them both?

Dr. Kane: Restylane too is nothing short of incredible! Only two years ago, collagen, which cost almost as much as restylane now does, lasted 3 to 6 weeks and caused inflammation in many patients so they could not use this filler. Restylane is not a structural protein like collagen, but a long connected sugar molecule, which due to its attraction to water, holds water for 4 to 12 months in many of my patients. It therefore gives a fuller yet softer look just as normal well-hydrated skin does.

Chemodenervation (botox-A) and fillers do not perform the same job. To understand this we must understand the four aspects of skin aging:

• stratum corneum (outer skin layer): thickens
• Epidermis and dermis: thins and loses function
• Subcutaneous layer (fat): thins
• underlying muscle: thickens

Now we can understand where each of the substances and techniques work:

• stratum corneum: acids to thin and exfoliate
• epidermis and dermis: Retin-A to stimulate turnover and regulate cell function and pigmentation, stimulate thickening of dermis, collagen, elastin, GAG production and vascularity
• Fillers for lines, wrinkles and furrows
• subcutaneous layer (fat): replace fat or near future Restylane SQ
• underlying muscle: Botox weakens and rebalances muscles

Dr. Dyson: Do you think more men will be attracted to cosmetic medicine and anti-aging services in the future and why?

Dr. Kane: Yes, men have shown a greater interest in cosmetic medicine, anti-aging management and skin care. This is because the marketplace for both significant others and maintaining or finding a job has become more and more competitive. Men are concerned more than ever about the degenerative diseases of aging including cardiovascular disease, cancer and arthriti,s so many are looking for healthy lifestyles and proper medical direction.

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Dr. Kane practices at The Center for Anti-Aging Medicine and Cosmetic Surgery, which is, located at 1 Reservoir Circle, Suite201, Baltimore, MD 21208. For more information, call 410-602-3322 or visit the web site at www.drdeankane.com

Dr. Dyson's practices at The Change for Life Weight loss and Aesthetics Center, which is located at 650 Pennsylvania Avenue, SE, Suite 250, Washington, DC 20003. Services include Botox, Restylane fillers, chemical peels, and mesotherapy. For more information call 202-575-4660 or visit the website at www.changeforlifeweightloss.com.

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