www.drmanishshah.com

For many years now, a popular high school graduation gift has been a nose job or otoplasty (ear pinning). In more recent times, that evolved into breast implants. Since the inception of Instagram in 2010, plastic surgery has seen an enormous rise in teens requesting lip fillers, Botox, and buttock augmentation.  Teens seeking to morph into someone else is fueled by studies that show that “The average millennial takes over 25,000 selfies in his or her lifetime, which is astronomical and one of the major reasons for the self-esteem issues in this age group.” More than 40% of surgeons in a recent American Academy of Facial Plastic and Reconstructive Surgery survey said looking better in selfies on Instagram, Snapchat, and Facebook was an incentive for patients of all ages undergoing surgery.  Dr. Manish Shah is a Denver board certified plastic surgeon. He wants to help teens, and parents of teens, navigate this world of teens and plastic surgery to discuss what is appropriate and at what age in a culture where it can seem as if everyone if having something done.  He understands this quandary as he is not only a plastic surgeon but a father of 3 teenagers.

Breast reduction

Some teens suffer from Juvenile Breast Hypertropy (enlargement). This often results in teasing, name calling, difficulty with exercise and clothing selection problems. It is reasonable to perform breast reduction surgery on these girls after the age of 16. This procedure is performed under general anesthesia and the breast tissue is sent off for pathological evaluation. Recovery tends to be less than two weeks with minimal overall risks. Even though breast reduction can help, these young women are at risk for significant re-enlargement in the future, especially with pregnancy.

Otoplasty (ear pinning)

Kids get teased for having “Dumbo ears” quite routinely. We become aware of the “other” in our lives after the age of 6. Otoplasty can be done at any age after 6. It is a safe surgery that can be easily performed in the office under local anesthesia. 

 Rhinoplasty

There are few things a teen can do to hide a nose that they are not happy with or get teased about. Teens can have rhinoplasty surgery, but only after their faces have completed growing. For girls that can be as young as 14 years old, and for boys, it is typically around 17 years old. Often, teens have additional problems with nasal obstruction from trauma as kids. This can be fixed at the same time as the cosmetic surgery. Insurance will often cover the medical portion of the surgery, but the cosmetic portion is usually an out of pocket expense. Recovery tends to be quite easy, and the boost in self-image is often immediate.

Liposuction

Liposuction for teens is not a common procedure. For most teens, they can achieve healthy bodies via proper diet and exercise. Frankly, this is better for them. After 15 years of practice, I can say that I have never performed liposuction on anyone younger than 18 years old. In modern times, we have seen an increase in sedentary behaviors with kids and this has been key in leading to childhood obesity. Frankly getting out to play is the best medicine!

Butt Implants

Butt implants are not a procedure that teens have performed. I reserve this procedure for patients older than 22 years old who have failed exercise as a method for gluteal muscle enlargement and are not candidates for a fat transfer to the butt (Brazilian Butt Lift).

Breast Implants

The American Society of Plastic Surgeons recommends that breast implants, especially silicone implants, not be used in patients less than 22 years of age. This is primarily for reasons of patient maturity and possible early family planning. In my practice this has been the case typically; however I have placed silicone implants in patients as young as 18 years of age because they were financially independent, mature, and already had children of their own. It is important to individualize each patients’ needs to deliver appropriate care.

Botox/Dysport in the Forehead and Crow’s Feet

With today’s access to technology, everyone is squinting to look at tiny screens. Over time, this increases complaints of eyestrain, headaches, and wrinkles. I think neurotoxin can be injected for patients as early as 18 years old, and earlier if treating for migraines. I started injecting my youngest daughter when she was 16 years old because of migraines. The treatment has helped her tremendously. As many parents know, teens have it hard enough as it is, but when they have migraines, it can have fairly negative effects on their lives. The risk of neurotoxin injections is low when parents take their teens to expert injectors. In my practice I perform all injections and I have for almost 17 years!

Chin Implant

Chin implant surgery can be performed in teens after their faces have finished growing. It is a procedure that is often combined with rhinoplasty, and/or chin liposuction to create a better jawline in those whose jaws are underdeveloped. If a patient is not a candidate for jaw surgery by their dental surgeons, they often seek out plastic surgeons for this combination of procedures.

Lip Fillers

Lip fillers are not really something I perform in those younger than 18 years old. There isn’t a significant justification for lip augmentation in this population. After they turn 18 years old and are legally adults, then I have no problem injecting filler as the risks are better understood at this age. Teens have had to grow up much faster than their parents did at the same age. The pressures to conform to fairly artificial beauty standards are high and parents need to help their teens resist these pressures until they are more mature.

Lasers

Lasers for teens are common in two particular scenarios: laser resurfacing for acne scar reduction and laser hair removal. Since teenage acne is ubiquitous, scarring is the big problem afterward. Once teens get their acne under control with the help of a board-certified dermatologist, they can undergo laser treatment to soften the scars and reduce pigment. When excess facial or body hair is a source of emotional distress for a teen, laser hair removal treatments can be used to reduce the problem. Both procedures can be performed after the age of 16 years old with parental support and consent. As there are significant risks with both procedures, I always recommend they consult with experts in skin before having any procedure.

 Filler in the Cheeks

I don’t recommend that teens get fillers unless it is to balance off major facial asymmetries that are congenital.

What makes some teens ready for cosmetic surgery and why would you turn away others?

For a teen to be ready for cosmetic surgery, it is necessary that they have family support, both emotionally and financially. They need to display a level of maturity that shows that they have done their research and understand the pros and cons of having a particular procedure. When I turn a teen away, it is most often because they clearly don’t exhibit a level of maturity, understanding, and rationality necessary to make a good decision for themselves. Their ability to consent to treatment is impaired. Often, there is a power struggle between the teen and the parent that clues me into the fact that they are not ready for surgery.

 Are there specific procedures you just won’t do under a certain chronological age, and if so, which procedures are they?

Honestly, most of the body procedures are off limits in my practice until the patient is at least 18 years old. I will perform breast surgery on patients with congenital breast deformities before the age of 22 years old. However, routine cosmetic breast surgery can wait until the patients are more mature. Outside of rhinoplasty and chin implant surgery, most facial procedures aren’t appropriate before a patient is in their twenties.

In summary Dr. Shah feels strongly that, “Parents need to have frequent conversations with teens who seem obsessed with selfies and plastic surgery. Adolescents must understand that their idols like Gigi and Bella Hadid, the Kardashians, Cardi B, and others, make their living off their faces and bodies. They represent only a tiny fraction of the general population.  Parents need to stress that while looks do count, so too does brains, ambition, personality, good choices, and talent. In general, the bulk of cosmetic surgery should be reserved for adults who are fully actualized people and want to make tweaks with realistic expectations and motives.”

Each year brings with it fashion trends, decorating trends, and beauty trends. The latter covers everything from nails, haircare, makeup and skincare. With the ubiquity of social media, beauty users now can pick up popular trends from anywhere across the world and follow them. Skincare is the biggest segment in the beauty industry with global sales that hover around $130 billion in 2019. There is so much for consumers to digest and decide on. We turned to Dr. Manish Shah, a Denver Board-Certified Plastic Surgeon and skin care expert. He takes a microscope to some of the hottest trends in 2019 to give insight into what’s worth your hard- earned dollars.

CBD In Skincare

Much like it did in 2018, CBD is taking off in the new year. In fact, CBD (short for cannabidiol) has no plans of easing up its reign on the skin-care world in 2019. As a case in point, there are at least two MAJOR skin care brands that now include CBD in their skincare, not to mention the indie companies who have created CBD skincare.

Dr. Shah’s take: “As far as it being good for skin, it acts as both an anti-inflammatory agent and an oil reduction agent. Theoretically, its addition to skin care products, especially those tasked to fight acne and other inflammatory skin conditions, is probably legitimate. It is also a good antioxidant that can help protect against free radical damage to skin cells. CBD can be made from hemp which helps skincare companies get around the federal ban on marijuana. Side effects of unregulated use include: Nausea, fatigue and irritability. CBD can increase the level in your blood of the blood thinner coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does.”

Microneedle Patches

Some beauty editors and bloggers swear by pimple patches. According to experts, those patches are about to get even more advanced by way of a ton of tiny microneedles (or “microstructures”). The logic is that you can out put a smaller amount of acne-fighting ingredients into these tiny little cones and apply it to the skin. It’s a better, more effective delivery system. Here’s how they are purported to work: The small band-aid-like sticker has spikes coated with hyaluronic acid or other chemicals that are thinner than a hair follicle. Through these teeny painless pricks in the skin, the patch drives the active ingredients deep in to the skin.

Dr. Shah’s take: “There is plenty of good medical literature on the validity of these small patches that are impregnated with various chemicals. The patch gets worn and the needles (either metallic or made out of absorbable polymer) penetrate the skin delivering the chemical treatment. Their design takes advantage of the concept of transcutaneous delivery of drugs. Patches can be custom made to fit various areas of the face and deliver anti-aging or other chemicals while a patient sleeps. The efficiency of delivery is better through the tiny skin punctures than if you only put the chemical directly on the intact skin. In theory, aesthetic practitioners can make custom topical treatments and place them on the patches to deliver customized at home skin treatments for their patients.”

Is a Cryotherapy Facial the Best Way to Brighter, Tighter Skin?

Cryotherapy has gained popularity in recent years with spa treatments exposing clients to subzero temperatures to help relieve pain and improve their health. This wellness treatment has recently undergone another adaptation with the cryotherapy facial treatment. The Cryo Facial is a cryogenic treatment that is performed by what is considered a “cryo probe,” which beams vaporized liquid nitrogen across the forehead, cheeks, nose and chin. Different from the cryotherapy chambers that can be used for pain relief, the facial targets helping the face look younger.

Dr. Shah’s take: “This may be more suspect. There isn’t a great deal of study-based evidence that cryotherapy facials actually do what they claim. Typically, cryotherapy uses extremely cold liquid nitrogen to freeze exposed skin cells to kill them, like a wart. The facials use the same liquid nitrogen as a spray, but the aesthetician doesn’t stay in one area too long to avoid frostbite to the skin. Some level of cold injury occurs, probably to a very superficial level of the skin, so there may be some exfoliation. But there are safer ways to get exfoliation without risking frostbite or hyperpigmentation.”

 Anti-Pollution Skin Care

Your skin is exposed to environmental aggressors on a regular basis. Although unseen, these pollutants can wreak havoc on your skin by breaking down collagen and elastin, the fibers that give skin its bounce. To help reduce these unwanted side effects, anti-pollution skin care products are continuing to gain favorability among consumers. Just as SPF is now de rigor in skin care, this seems to be the case with anti-pollution ingredient.

Dr. Shah’s take: “I think that this is a new name for old tech. In brief, our skin is exposed to environmental contaminants that create inflammatory conditions. These conditions lead to build up of free radicals in the skin. The ingredients in antipollution skin care are basically strong antioxidants that protect against the free radicals. But the skin is assaulted by more than chemicals. It experiences dehydration, UV exposure, temperature changes, etc. True antipollution skincare should guard against all this. Typical protective and reparative ingredients include vitamin E, vitamin C, retinoids, hyaluronic acid, zinc oxide, vitamin B3, and bisabolol.”

Dr. Shah’s final verdict: Just as one can become a slave to fashion, the same can happen with skin care trends. My best advice is to consult with your skincare physician. Discuss what you are exposed to during the day.  Is it sun, pollution, humid air, wind, etc.? Talk to your doctor about what type of skin you have. Skin type changes as you age, and as hormonal factors come into play. Someone who had oily skin in their 20’s and 30’s can have combination skin in their 40’s and 50’s. Speak with your aesthetic provider about what your specific goals are for your skin. Is it reduced acne? Fewer wrinkles? Reduced brown spots? Broken capillaries? Just because something is a trend, does not mean it’s right for your skin care type or your goals. If you have a regimen that works for you, stick with it.  Don’t be tempted by designer brands if drugstore brands are effective for you. There is nothing wrong with giving your skin care routine a modern “kick,” but good skincare does not mean one must try everything available on the market or in a med/spa or doctor’s office.

Every decade there is a celebrity who sets the bar for beauty. Dr. Manish Shah, Board Certified Plastic Surgeon based in Denver, takes nostalgic look at these classic beauties through the decades and points out what today’s women would critique about them given today’s beauty standards. We also have an interesting look at predictions for what the beauty ideal will be as we approach 2020. We already see a shift taking place to a strong body, smaller breasts and a more natural facial aesthetic. Let’s look forward by first looking back.

1950’s Marilyn Monroe, the Ultimate Icon

Marilyn Monroe is still a beauty icon and despite transforming from brunette to the ultimate blonde bombshell, she is still the embodiment of sex appeal. “Marilyn Monroe was infamous for her hourglass physique, sexy lips and dreamy eyes. Today’s women would consider her “curvy” and would suggest Marilyn get inner thigh liposuction to achieve “thigh gap,” which became a thing over the past few years. I say Marilyn was gorgeous, feminine plus she knew how to dress for her frame. At 5’5” 120-130 pounds she was proportioned and looked lovely,” says Dr. Shah.

1960’s Raquel Welch, the Glamazon

Raquel Welch embodied the exotic bombshell. With a Bolivian father and an Irish mother, Raquel’s features were unique and stunningly beautiful. “What’s interesting about Raquel Welch is that she was all natural and women of today would want her body. She wasn’t skinny at all with beautiful full breasts, athletic legs and beautifully symmetrical facial features. She’s also aged gracefully over time, and still looks elegant well into her 70’s,” Dr.  Shah points out.

1970’s Farrah Fawcett, the Girl Next Door

In this decade we see a shift from the voluptuous to the slender with a more girl-next-door approachable look. “Farrah’s lips are actually quite thin by today’s standards yet, they work perfectly with her other delicate facial features. Her megawatt bright smile was what supercharged her look. In the 70’s, plastic surgery wasn’t as mainstream as it is today. Women simply went to the hair salon for the Farrah Fawcett feathered hairstyle. At 5’7” Farrah had a 34B breast size which we are seeing a return to,” explains Dr. Shah.

1980’s, Brooke Shields, Endless Beauty

Time magazine put her on its cover with “The Face of the 80’s.” During that decade Brooke was known for her natural bushy eyebrows. According to Dr. Shah, “Brooke’s facial symmetry was and still is exceptional, her nose is perfect for her face and everything just worked together. One thing I can see today’s women suggesting for the 80’s version of Brooke, would be breast enhancement, something she never had nor wanted. Brooke now 53, looks radiant and relies on diet and exercise to maintain an age appropriate, classy look minus the need to overdo it with fillers and unrecognizable facelifts. Brooke looks like an older, gorgeous version of herself.”

1990’s Kate Moss & Pam Anderson, The Waifs vs. The Beach Bunny

The early 90’s beauty aesthetic was highly driven by the Grunge Rock music scene. The “waif” which was embodied quite controversially by Calvin Klein model Kate Moss and actress Calista Flockhardt, known for her popular TV character Ally McBeal. Both were scrutinized and shamed for being “too thin” pressuring other Hollywood celebrities to keep up. On the other extreme was bombshell, Pamela Anderson of the iconic Baywatch TV Show of the same era. A favorite of Hugh Heffner, who considered her to be the ultimate bombshell, put her on the cover of Playboy a total of 13 times in the 90’s and first decade of the 2000’s. “Pamela Anderson absolutely boosted demand of breast implants in the 90’s and made it much more mainstream to look more like an exotic dancer than a fashion model. I’m glad to see that Pamela, now in her late 40’s, didn’t overdo it with any facial plastic surgery and opts now for a more elegant look,” offers Dr. Shah.

2000’s, Livin’ LaVida Lopez

In February of 2000, Jennifer Lopez and her ample derriere got massive global attention for the infamous green Versace dress she wore as Grammy presenter. She was already turning heads on the red carpet as an actress and singer. “Jennifer Lopez was the first woman to bring attention to a curvy fuller butt. The Brazilian Butt Lift came into popularity to meet the demand of more women wanting a curvier, fuller, yet lifted bottom. What’s great about Jennifer Lopez is that she’s now in her late 40’s, with a packed schedule which demands that she is in excellent physical shape. Her physique is very athletic and muscular yet, feminine at the same time. This is a woman who did a triathlon months after giving birth to twins. Jennifer has maintained herself exceptionally well through the years with facials and lasers which can help women ward off any need for a face lift,” says Dr. Shah.

2010 – Present… Keeping Up with the Kardashians

“The Kardashians were the tipping point to both surgical and non-surgical treatments going to another level and they built an empire out of all of it,” says Dr. Shah. If you watch old episodes of the show you see Kim, sisters Khloe and Kylie and momager Kris radically changed their appearance. Plus, they are always touting procedures such as Kim did with the “Vampire Facial.” Kylie Jenner looks like a totally different person than she did as a teen just 4 years ago. Her admitted lip injections gave her a new facial appearance that now has her at the top of the family income chain.

2018 and Beyond… All Eyes on Kendall Jenner

Kendal Jenner is the hottest model right now and the face of Estee Lauder. While part of the Kardashian clan, she’s an actual model with extraordinary bone structure, long legs, and a body for high fashion. “I predict we will see a new crop of beauties like Kendall Jenner, Bella Hadid, and Kia Gerber (daughter of Cindy Crawford) set a new more fashionable aesthetic. I’m hopeful that the over-done lips, the over-filled faces and over-sized breasts will fall away with a shift to preserving ethnic features and body type for a more interesting, less generic “done” look, says Dr. Shah who prides himself on delivering a more natural look.  

We all know that cosmetic-plastic surgeons and dermatologists earn their living by operating or non- invasive procedures. Most of these endeavors are costly for patients.  It’s rare that any aesthetic surgeon will let us in on things we can do daily that don’t require us to visit them!  We are fortunate to have Dr. Manish Shah, a Denver board -certified plastic surgeon share secrets with us, that in many cases cost nothing or less than a gourmet cup of coffee.   

DR. MANISH SHAH’S TOP BEAUTY HACKS

1. Cleaning your phone screens- Dr. Shah offers that, “A great way to avoid blemishes is to routinely clean the makeup and bacteria off of your phone screens. It is easy to spread harmful skin bacteria from the surface of your phone. Washing your hands goes a long way to avoid skin contamination as well.”

2. Make your own exfoliating scrub at home- Dr. Shah shares that, “A woman I consider my second mother taught me how to create my own organic exfoliating scrub. She would dry peeled skins of oranges, lemons, and limes in the sun. She would then finely grate the white inside rind of the peel and then mix it with any facial cleanser or even add it to fine facial oils. Using the scrub would exfoliate the skin, treat it with Vitamin C, and prevent over-drying of the skin because of the fruit oils.”

3. I recommend treating the enlarged pores of the T-zone with over the counter hydrogen peroxide. The bacteria in the pores create inflammation that increases pore size, and this leads to blackheads and whiteheads. Dr. Shah explains that, “These bacteria can’t survive in high oxygen environments. 3% hydrogen peroxide is available over the counter quite inexpensively. Treating only the T-zone at night kills the bacteria, reduces pore size and  blemishes. Because it can be quite drying, takes breaks from its use every now and then.”

4. Avoid fake nails.They harbor tons of bacteria that are easily transferred to the face when you touch your face. Instead, focus on growing your own nails with the help of oral vitamin C and any good quality hair, skin, and nails vitamin like Nature’s Bounty Extra Strength Hair, Skin, and Nails.

5. For teens, especially, it is so important to wash their pillow cases routinely. Dr. Shah is the father of three teens. From his first-hand knowledge he says that, “Teens aren’t very compliant when it comes to skincare and they suffer from hormones in a bad way. This 1-2 punch makes acne and blemishes the bane of most teens’ existences. Going to sleep at night on clean pillow cases after washing your face goes a long way to reducing bacterial burden and allows blemishes to heal.”

6. If you suffer from puffiness around the eyes, a quick trick is to use black tea bags. Wet them in ice water and lay them onto the eyes to soothe. The caffeine in the black tea causes blood vessels to constrict, reducing edema or swelling in the delicate, thin eyelid tissues.

7. Add baking soda to your toothpaste to easily polish away stains to keep your teeth white. Instead of bleaching your teeth, baking soda actually breaks the molecules that stain the teeth. It is less irritating to your gums as well, and way cheaper than teeth whitening strips.

8. Eat the rainbow- A white bread-based diet does not for clear skin make. That’s why Dr. Shah makes sure his diet is packed with brightly-colored fruits and vegetables.  He says, “Fruits and vegetables are high in antioxidants which give glow to the skin.” Specifically, research suggests that pigments called carotenoids—found in foods like carrots, spinach and other leafy greens, and tomatoes have been linked to good complexions.” Adding fish oil to your diet also improves skin compliance and radiance.

9. Avoid Hot Showers- Disappointing as it may be, Dr. Shah says, “Hot showers remove too much of your natural oils and brings blood circulation to your skin, creating inflammatory reactions that result in rashes and aggravate those with eczema or dry patches.”

10. You may just need a brow wax instead of a lift- “I had a patient who wanted a brow lift because she thought she looked angry all the time. I sent her for a brow wax instead. It took 15 minutes, she looked great, and she saved herself thousands.” Other brow techniques like brow tinting can change how your eyebrows frame the eyes, improving on your looks.

 

 

It’s something every woman fears: Waking up on the day before or day of a big holiday party with an unsightly skincare emergency. How many women have cancelled an invitation because a cold sore erupted? How about cystic acne on your chin that appears New Year’s Eve? While neither of these are “life threatening” conditions, for a woman, they might as well be. There are solutions. Dr. Manish Shah is a Denver Board Certified Plastic Surgeon. As a father to girls, he can relate to these skincare 911s and shares his expertise on what can be done to mitigate various conditions.

Problem: Cold Sore

Solution: Dr. Shah offers cortisone injections to patients who want to look better faster. “Very diluted cortisone into the cold sore, this can bring the inflammation down quite rapidly,” he says. If you are afraid of needles, call your doctor and ask him/her to call in a prescription for Valtrex, Famvir, or Acylovir, Dr. Shah says. You can pick up Abreva, an over-the-counter medication. If you can’t make it to the pharmacy, you can try some old-fashioned remedies: Visine will help take the red out. You can also use a cold compress and Tylenol or ibuprofen. 

Problem: Allergic Reaction

Solution: The first thing you need to do is stop eating or using whatever is causing the allergic reaction. If the reaction happens a few days before an occasion, Dr. Shah recommends using hydrocortisone cream twice a day and taking Allegra, Claritin or Zyrtec which are longer acting and less sedating than Benadryl. Try a whole-milk compress for 10 minutes twice a day. For allergic reactions, use the hydrocortisone cream and then cover up redness by canceling it out entirely. The opposite of red is green, so apply green tinted concealer on the red area. The combination will create a flesh-toned hue. A good quality tinted moisturizer naturally has green/yellow undertones and also provides moisture to dry skin. “If this type of reaction is something you have never experienced before, go immediately to your dermatologist,” says Dr. Shah. 

Problem: Cystic Acne Breakout

There are some people who use a lancet or small knife to cut into a cyst and fish out the clogged part of the pore. “Cutting open a cyst is extremely risky. You not only run the risk of getting an infection, but you also run the risk of scarring, as in a permanent skin indentation or protrusion,” says Dr. Shah. And what if you cut open a cyst but can’t squeeze out the root clog? You don’t know where the root is or how deep it resides inside your skin. You can’t even be 100% confident that you will be able to completely remove the hardened plug of the cyst. If any remnants of the clog remain, the cyst is likely to get re-inflamed and come back even worse. It’s also not exactly good to cut open skin and dig around and squeeze the wound. Doing so will only make a bloody mess, increase the chance of skin scarring, and prolong the time it takes the cyst to heal. 

Solution: Here’s a secret that many a supermodel or actress use: Steroid shot. Dr. Shah explains that, “when we discuss treating acne with cortisone or “steroid” shots, we are referring to the process of gently placing a very dilute quantity of a “glucocorticoid” steroid into the cyst. Glucocorticoids are a class of steroid molecules that are naturally produced by our bodies and have numerous functions including the regulation of human metabolism, immunity, and inflammation. They have very potent anti-inflammatory effects, so they are often used to treat inflammatory diseases in medicine. They can be formulated as creams to treat skin rashes or as pills to treat systemic disease. They can also be injected directly into local areas of inflammation such as in arthritic joints and inflamed acne cysts. Within one or two days of injection into a cyst, the steroid will shrink the inflammation producing relief of pain and almost immediate cosmetic improvement.” 

Problem: Puffy Eyes

Solution: The key to reducing the puffiness of puffy eyes is having something cool applied to them. “A cool compress or cooled cucumber slices applied for 5 to 10 minutes can constrict blood and lymph vessels,” says Dr. Shah. You can also use cool tea bags, which contain tannins that will help reduce swelling. And since puffy eyes can be caused by a high salt diet or alcohol, try to cut out both before an important occasion.

Problem: Sunburn

Solution: Take a cool bath or shower. Set the water to a cool temperature that’s just below lukewarm and relax for 10 to 20 minutes. The temperature will ease the pain, and the water will stop your skin from becoming as irritated. Repeat as often as you need to. Avoid using soap, bath oils, or other detergents as you bathe – they’ll irritate your skin and possibly make it even worse. If you have blisters forming on your skin, take a bath instead of showering. The pressure from the shower might pop your blisters. When you get out, don’t rub your skin dry with a towel. Instead, let yourself air dry, or pat the towel over your skin in small, gentle movements. Apply cold compresses to your skin. If you’re not in a situation where you can bathe, or you’d just prefer not to, you can instead apply cold, wet compresses to your skin. Dampen a washcloth or other piece of fabric with cold water and lay it over the affected area for 20 to 30 minutes. Re-wet it as often as you need to. Apply aloe vera to burned skin. Using the pads of your fingers, gently apply the aloe to your sunburn. Don’t “rub it in” all the way, like you might with a regular lotion. Leave it a bit goopy and moist on top of the burn – this helps prevent the skin from drying out and becoming more irritated. Reapply as often as necessary. Treat inflammation with cortisone cream (optional). Cortisone creams contain a small dose of steroids that can work to reduce inflammation to your sunburn.

Problem: Too much filler

The Solution: Dr. Shah suggests doing fillers no sooner than 1 month before a big event to allow time for healing and touch ups. One of the reasons Dr. Shah leans toward hyaluronic acid fillers such as Restylane, Juvederm and Perlane is because they are easily reversed with Hyaluronidase. This product dissolves and degrades the Restylane, Juvederm or Perlane so as to reverse the results of the initial injection. It’s a great insurance policy when choosing a practitioner. Make sure yours has it at his/her disposal. Most patients find the immediate results of soft tissue filler treatments very satisfying. If an undesirable result occurs, your treatment provider should be able to discuss and carry out all of the treatment options. Removing the effects of a “filler” treatment can be difficult. This is why any filler treatment needs to be done carefully, conservatively and only by very experienced and Board-Certified specialists. Hyaluronic Acid based dermal fillers have the additional benefit of being partially or completely reversed with time or with the injection of a commercially available enzyme known as Hyaluronidase (Hylenex).

Many people in their 20’s are stressed out about high post college student loan debt requiring side hustles to pay it off. They’re noticing tired eyes and premature wrinkles as they turn to filters to optimize their social media photos. There is pressure to keep up with celebrities their age not to mention the countless millennial “social media influencers” who are setting the new standard for beauty and youth. Bottomline, millennials are stressed, and they don’t want to look it. Dr. Manish Shah, a Denver, Colorado Board-Certified Plastic Surgeon who specializes in facial plastic surgery urges the under 30 crowd not to overdo it with expensive treatments and procedures that can actually make them look older and put them further into debt.

 Here is Dr. Shah’s of 6 things millennials can do to maintain their youth.

1. Use sunblock every day.

“The best way to make sure your face is protected from the sun is to use a daily moisturizer with SPF of no less than 30,” explains Dr. Shah. He also suggests applying creams to your neck and chest to postpone wrinkling and sagging in these areas. “The sun protection done daily in your 20’s will pay off greatly in your 40’s,” he says.

2. Get your Vitamin C.

“Vitamin C is a huge collagen booster and it also reduces pores and brightens skin, and these are the exact things women in their late 30’s and 40’s complain about most,” he reveals. Foods such as cantaloupe, mango, pineapples, oranges, grapefruits, and berries are all packed with this antioxidant which, when eaten regularly does wonders to sustain a youthful glow. 

3. Ditch the fast food and eat more fish.

Those late night post partying fries and pizza are to be expected and at 25 are difficult to avoid. Perhaps your metabolism can handle it, for now. Offset these weekend indulgences by eating fish during the week. “Fish oil has fatty acids can erase early wrinkles you may notice. It prevents inflammation which can only make wrinkles more noticeable and deeper over time. Many millennials who are picky eaters and avoid seafood can get Omega-3’s via supplements but getting it directly from eating fish is best,” Dr. Shah suggests.

4. Quit smoking.

Nothing will age you quicker than smoking. “It is possible for a 25-year-old to look 8-5 years younger, within just 3 months after quitting smoking. This number increases after age 30. Women over age 40 who don’t smoke typically look up to a decade younger than their counterparts who still smoke,” says Dr. Shah. There are a gazillion reasons to quit smoking. Linking it to vanity is a pretty powerful motivator.

5. Decrease your sugar intake.

You really want to start getting mindful about your sugar intake in your 20’s for many different reasons. “Sugars and carbohydrates are a beauty killer because they are pro-inflammatory. Pasta, ketchup, candy, ice cream, and fruit juices are often dietary staples for those under 30. Any inflammation in the body will show up on the face in the form of adult acne, sagging and wrinkling not to mention sallow skin tone,” warns Dr. Shah. 

6. Maintain your glow with facials and peels.

While many millennials are starting off with “Baby Botox” which can postpone wrinkling, Botox isn’t cheap. It also can be a “gateway” treatment which leads to lip injections and fillers that often have a reverse effect making younger women appear older, cautions Dr. Shah. “Lasers and peels have come very far, offer an excellent solution for sun damage, skin texture, pores, acne scarring and cell turnover to stimulate collagen growth.

Dr. Shah concludes that millennials who get into a good solid habit of taking care of themselves both inside and out, will create a lifestyle of longevity. “Millennials raised by mothers who may have had breast implants, Botox and lip injections may feel that getting things “done” is normal. This is exactly why I am always very honest when advising patients under 25 on procedures they’re considering.”

As luck would have it, most women seem to experience skin care problems just when they want to look their best. Every woman can relate to waking up with a huge zit right at the tip of her nose, or huge dark circles under the eyes, and the list goes on. There are pre-emptive measure one can take with less than two weeks until the New Year to ward off these skin care evils. We turned to Dr. Manish Shah, a Denver board certified plastic surgeon for guidance on what to do without breaking the bank or having invasive surgery.

Facial Extractions by a licensed aesthetician– Dr. Manish Shah says, “When done correctly extraction facials can clear closed comedones (AKA those tiny, flesh-colored bumps that never come to a head, yet never really go away), remove whiteheads and blackheads, and give your skin a newer, fresher foundation for your skincare products to penetrate. Basically, extractions can be the kiss of life for your lifeless broken out skin.”

Drink Alcohol in Moderation

If you plan on ringing in the New Year with a few glasses of bubbly, Dr. Shah recommends moderating your alcohol consumption leading up to the big day. He explains, “Alcohol can dehydrate the skin and cause it to appear less fresh and vibrant, which can certainly hinder your skin care efforts.”

Cleanse your Face Every Night- You have just arrived home at 2 am from a holiday Party. It may be tempting to flop into bed without washing your face. Don’t do it! Dr. Shah says that, “Sun damage isn’t the only environmental factor you have to worry about. Small micro particles from air pollutants might just hurt your skin, too. Play it safe by remembering to take a minute to cleanse your face to remove debris that could be weakening your skin. In addition, that foundation and pressed powder you have been wearing all night can clog your pores and cause breakouts.”

Start Exfoliating

Want brighter, younger-looking skin? It starts with a great at home exfoliator! Dr. Shah explains that, “As your skin replenishes itself, dead skin cells start to build up on the top layer, leaving you looking dull. Exfoliating regularly removes this layer, revealing fresh, healthy skin. Regular exfoliation also allows your moisturizer and other topical products to penetrate more deeply, making them more effective.”

Clean Your Makeup Brushes

You would not eat food on dirty dishes, would you? Applying makeup with dirty brushes is not so different. Not only will dirty brushes give you a spotty application, but they can harbor bacteria, dirt and oil, leading to acne and breakouts which necessitates piling on even more makeup to cover it up.

Don’t Squeeze Your Pimples!

Here’s a secret that many a supermodel or actress use: Steroid shots. Dr. Shah explains that, “when we discuss treating acne with cortisone or “steroid” shots, we are referring to the process of gently placing a very dilute quantity of a “glucocorticoid” steroid into the cyst. Glucocorticoids are a class of steroid molecules that are naturally produced by our bodies and have numerous functions including the regulation of human metabolism, immunity, and inflammation. They have very potent anti-inflammatory effects, so they are often used to treat inflammatory diseases in medicine. They can be formulated as creams to treat skin rashes or as pills to treat systemic disease. They can also be injected directly into local areas of inflammation such as in arthritic joints and inflamed acne cysts. Within one or two days of injection into a cyst, the steroid will shrink the inflammation producing relief of pain and almost immediate cosmetic improvement.”

Peels

Look for AHA/BHA/PHA peels that will exfoliate the skin and help release the top layers of dead skin cells allowing for a more radiant underlay to come through.

Microdermabrasion

This professional treatment exfoliates at a deeper level (similar to a peel), with a mechanical handheld device that buffs away the upper layers of the skin.

Add vitamin C to your routine.

Dr. Shah suggests applying several drops of vitamin C serum underneath SPF each morning to target free radical damage, help lighten brown spots, and even out your skin tone.

Moisturizer

It may seem obvious, but when it comes to dewy, glowing skin, moisturizing is essential. “When your skin is dry, it looks dull, so hydrating ingredients can help bring back that glow,” says Dr.  Shah. For skin types already prone to shine, adding moisture may seem like the last thing you need, but an oil-free hydrator with ingredients like hyaluronic acid could actually help reduce your sebum production and even out slickness into a sleek glow.

When it comes to your beauty routine, very few things are free, but sleep costs nothing and may be the closest thing to a fountain of youth. Dr. Manish Shah is a Board-Certified Denver, Colorado plastic surgeon.  A 2017 study found that two days of sleep restriction negatively affected participant’s perceived attractiveness, health, sleepiness, and trustworthiness. Dr. Shah explains that, “Your body repairs itself and recovers while you sleep, and that results in a long list of benefits for anti-aging and appearance.”  Most experts agree that 7-9 hours a night is ideal. It’s time to maximize your shut eye for anti-aging.

Here are Dr. Manish Shah’s Tips for Beauty Sleep

Sleep on Your Back

“Sleeping on your stomach or on of your sides means there is constant pressure on your face. Over time, this action will produce unwanted sleep lines. You can remedy this by sleeping on your back,” says Dr. Shah. This way you will not apply any pressure to your face. For many people though, this might be uncomfortable, and you can’t control your involuntary sleep movement leading you to a side or stomach position. You can practice and can get used to it over time.

Use an overnight product and put a glass of water on your bedside table

Washing your face can dry it out and sleeping can also dehydrate skin, especially if you snooze in a low-humidity environment. While staying hydrated by drinking water can help to some extent, what your skin really needs at night is a topical moisturizer. For a more supercharged product, try an overnight sleeping mask such as https://brazilianskin.com/collections/all-product/products/acai-triple-stem-cell-complex-mask This is an Acai Triple Stem Cell Complex for $59.99.  Potent Açai Triple Stem Cell Complex Mask is an overnight mask application crafted with an innovative, breathable, and nourishing film ingredient that functions as a transdermal penetration medium to facilitate the complete absorption of the “Grams Triple Stem Cell Complex.”

Pillowcases Make A Difference

Dr. Shah explains that, “While facial creasing has a lot to do with sleep positioning, a change in pillowcase might be the answer. There are numerous benefits of silk for good sleep. Silk pillowcases are a great way to wake up creaseless in the morning. The smooth texture of silk is gentler than cotton and may help prevent sleep wrinkles, as well as reduce skin irritation. Its tightly woven fibers also don’t draw out moisture and natural oils as cotton does, leaving your skin better hydrated.”

Stay away from salty foods and alcohol around bedtime.

If you’re craving a midnight snack or drink, be mindful. While some foods, a light, carb snack like crackers or an apple, can actually help your sleep, many others can disrupt your sleep and wreak havoc on your appearance. Alcohol and salty food can have a dehydrating effect on the body. To compensate, your body starts collecting natural fluids around the eyes, among other places, leading to that dreaded puffy-eye look. Dehydration is claimed to lead to formation of dark circles under the eyes.

Wear your hair up — but not in a tight bun.

It’s a good idea to keep your hair out of your face while you’re sleeping to keep its natural oils from wreaking havoc on your complexion. But avoid pulling it into a really tight bun or ponytail because that can cause hair breakage, especially around the hairline. Dr. Shah suggests wrapping it up in a scarf (silk would be ideal).

Keep makeup remover by the bed

“No matter how tired/drunk you are, going to bed with your makeup on will only be worse the morning after (clogged pores, irritated eyes, oily residue etc.). Make it less of a chore by keeping some good-quality face wipes by the bed for a fast, effective cleanse. It’s not ideal to rely on convenience cloths every night in place of a deeper clean, but on late nights they are skin saviors, says Dr. Shah.

Wear A Silk Sleep Mask

Avoiding light when you sleep is crucial to getting quality rest. Dr. Shah explains that, “An eye mask completely eliminates vulnerability to light, preventing it from interfering with your sleep. For the best results, use a silk eye mask. Since skin is susceptible to wrinkling, make sure that the material pressing against your face is as soft as possible.”

Keep the Temperature Low

At night, your body’s natural temperature declines. Keeping the temperature in your bedroom low is good for both your metabolism and your blood flow. Dr. Shah explains that, “This is important because improving your blood flow helps oxygenate your skin, keeping it plump and even-toned for the day ahead. Maintaining a cool temperature in your bedroom will also help reduce redness in your skin.” The National Sleep Foundation recommends keeping your bedroom between 60 and 67 degrees Fahrenheit for an optimal night’s sleep.

We are all subject to marketing and advertising on a daily basis. Nowadays it seems like even thinking about skin care will get you bombarded with countless ads and sponsored posts on social media. But how trustworthy are some of the marketing buzzwords used to describe the effects of skincare merchandise? We reached out to an anti-aging expert and board-certified Denver Plastic Surgeon, Dr. Manish Shah. Shah advocates helping consumers understand what this frequently used language means. Dr. Shah is also an ethical patient safety advocate.

“There are many ways marketers attempt to pull the wool over the eyes of the consumer with empty phrases and jargon,” comments Dr. Shah. “A phrase such as ‘clinically tested’ and ‘doctor recommended’ is used to mislead consumers into thinking a certain product has more credibility than it actually does.” However, Dr. Shah explains, when these phrases are used it says nothing for the results of the clinical tests or what the products were tested for. In terms of products being “Doctor recommended,” Shah warns that “consumers don’t know what doctor recommended the product in most cases and if those doctors are getting some sort of incentive for endorsement.”

Dr. Shah shares common marketing jargon phrases used to mislead consumers.

1. A Product that claims “Patented Technology”

“Patents are not necessarily a foolproof sign that something is groundbreaking or effective,” explains Dr. Shah. “Marketers use this language to convey innovation and superiority that their product might not necessarily have over its competitors,” he says. Patents are sometimes authorized through technicality instead of breakthrough meaning any new combination of ingredients, methods or production process can be patented as long as it is new.

2. “Maximum strength”

This is a term used often by skin cleansers and moisturizers. “It’s a relative term and the consumer doesn’t really know what it is relevant to. It’s language that entices the shopper to make the purchase without really telling them how it accomplishes ‘maximum strength’ results,” says the Denver Plastic Surgeon.  

3. “Clinical strength”

From painkillers to hydrating serums, companies love to bill their products as having “clinical strength.” Dr. Shah says consumers should practice healthy skepticism with such claims. “A product that claims it has clinical strength, in many cases, could have been tested by the doctors developing it. If you think about it you can’t really pinpoint what that phrase means because it is relative and we have no context as to what the company considers clinical strength,” says Shah. The perception, explains Dr. Shah, is that the product is better because the world clinical makes it sound more credible.

4. “For All Skin Types”

“This is a difficult promise to deliver on,” says Shah who has practiced his specialty for 14 years. “Not all skin is the same. If someone has an allergy to an ingredient or some form of dermatitis they really should speak to their doctor about what products are best to include in their regiment instead of blindly trusting a label,” he says.  

5. “FDA Approved”  

The FDA has different protocols for skincare products that make cosmetic claims as opposed to those that make more medical claims such as promising to increase production of collagen in the skin. Since that is a body function the FDA treats those differently than normal skincare products. However the FDA just stipulates that the product being sold is safe to use in the manner in which it is directed to be used “FDA approval is not credential that shows the superiority of results,” says Dr. Shah. The plastic surgeon recommends that you not be sold on the sole factor of an FDA approval.

6. “Anti-Aging, Revitalizing, or Age Defying”

We’ve all seen these on the labels of some cream or serum or advertised in a commercial where beautiful models and actresses are displayed in all of their airbrushed and well-lit perfection. “These terms are somewhat misleading in that they give the perception of an unrealistic turning back of the clock,” says Dr. Shah. To many consumers viewing an advertisement, it might seem like buy and using that product will help them look like an ageless actress and that is not accurate.” Aging gracefully and maintaining a more youthful look has a lot to do with nutrition, exercise, genes, consistent skin care, stress levels, and cosmetic procedures when necessary. But according to Shah, people cannot cling onto just one aspect in order to look their best and no one product will reverse the clock.

7. Medical-Looking Packaging

Be wary of bottles that look like test tubes, labels or packages that include a medical or first aid cross, or feature type that looks like Rx suggesting that it’s a prescription-strength formula even though it’s sold over the counter.

8. “Botanical”

Dr. Shah explains that “An actual botanic is technically an ingredient that is derived from a plant. But, again, “botanical” may be used in advertising to refer to something that is synthetic but acts similar to a plant-based ingredient.”

9. “Instant Results”

Keep in mind that “instant results” aren’t the same as “long-term results.” Meaning, you may use a product that gives you instant moisture or has a quick-acting firming effect, but those results may fade after a few hours and require reapplication. Dr. Shah’s final advice: “Check a product to make sure it specifies whether its “instant” effects are long lasting or short term.”   

10. “Firming”

What you think it means: Proven to make skin look tauter.

What it really means: Essentially nothing. “There is no objective way to measure firming,” says Dr. Shah “When a brand says their product has been shown to firm your skin, that claim can only be based on very subjective consumer perception.”

According to expert Board-Certified Plastic surgeons, the goal of cosmetic surgery is to make a woman like look a refreshed, enhanced version of herself. While many seek cosmetic surgery to turn back the clock; (a respectable, personal choice) there is a downside. The eerie expressionless, puffy, distorted, look that makes people appear even older than they are. To help us understand and achieve a more maintained, elegant look, we tapped the expertise of Board-Certified Denver Plastic Surgeon Dr. Manish Shah.

 Most Common Culprit… Too Much Filler

 According to Dr. Shah, the best way to begin is to look at photos of the person decades younger to assess their aging progression and facial symmetry. “You want to look at the facial features to see where there is drooping or volume loss as not to run the risk of over filling the face. When too much filler is used, facial balance is thrown off.”

 Dr. Shah explains that today we’re seeing young women in their 20’s trying to look like they’re photo filtered in real life. “They start Botox too young, or overfill their lips, breasts, and derrieres. The odd consequence is that that end up looking older. There are several celebrities who are under 25 and look 30, and 35 due to the work they’ve had done. The lips and cheeks are often the first facial features to be overdone in younger patients.”

 Facial Breakdown

 Cheeks: Dr. Shah says, that “Over-suctioning cheeks through liposuction can make you look older. Stiffness or “puffy cheeks” can also occur if there is unnecessary fat transfer or filler injections are overdone.”

 Brows: A highly arched eye brow, or a brow without any arch can instantly age you. “Getting the eyebrow height perfect to achieve a natural look is one of the most challenging techniques plastic surgeons face with Botox, be sure to find someone who specializes in brow area Botox.”

 Chin: “The overall balance of your face can be thrown off if a chin implant is too large,” says Dr. Shah. He adds, “Facial structure goes from more of a heart shape to a square shape. Also, the softness of your face gets lost.”

 Neck: Removing too much fat from the neck can result in an excessive deep and sharp angle that gives more of a harsh look.

 Midface: Some women get a facelift before it’s needed. Think of many of the stars of Bravo’s Real Housewive’s franchise. “When it’s unnecessary or not done properly, the underlying facial tissues give an unnatural fullness in the cheeks that makes the face look aged, explains Dr. Shah.”

 Eyes: Fat removal under the eyes is popular in younger patients. The problem is that removing too much fat can really make a patient look hollower rather than refreshed.

 Injectable Toxins: The Frozen Look

Botox, Dysport and Xeomin are all effective in reducing lines by temporarily paralyzing facial muscles to stop movement. Problems arise when they are overdone. The face can look very severe and certain facial features can become exaggerated. It is strange to see a woman over 50 with fewer forehead and brow mobility than a pre-teen!

 Dr. Shah offers a tip and reminds us that injectable toxins are not permanent, and the result will fade away in time. “It’s best to let the product completely wear off before getting injectable toxins applied to the face again. It’s always best to start off with much less because you can always work your way up to more,” he advises.

 Too Large Breast Implants:

Implants that do not fit a woman’s frame and are overexaggerated, are never a good idea at any age. The older a woman gets, the more this is going to scream, “look at me” and be incongruous with the rest of her appearance. Jane Fonda is a perfect example of a woman in her 80’s with implants that match her body in a flattering way.

 Ignoring Your Hands and Décolleté:

So many women make the mistake of obsessing over their face, legs, derriere, breasts, and abdomen that they completely forget their hands and décolleté. The latter are a dead giveaway of age, no matter how young the rest of you looks.

 Examples of Elegance:

According to Dr. Shah, here’s who he feels has “gotten it right” when it comes to aging gracefully whether they have had plastic surgery or not include, Jane Fonda, Jennifer Aniston, Jennifer Lopez, Halle Berry, Angela Bassett, Katie Couric, Raquel Welch, Kathie Lee Gifford, Kris Jenner, Naomi Campbell, Michelle Pfeiffer, Jayne Seymour, Ellen DeGeneres, Sharon Stone, and Padma Lakshmi. Use these celebs for inspiration when contemplating cosmetic enhancements.