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Skin Care Details Beverly Hills

Skin care is the process through which you protect, nurture, and repair your skin. There is not one optimum skin care regimen that applies to everyone, as your unique combination of characteristics requires an individualized approach. Over the last decade, plastic and cosmetic surgery has grown tremendously and these advances in surgical understanding in addition to the vast array of minimally invasive techniques available today have resulted in the increasing popularity and acceptance of cosmetic surgery procedures. Neo Surgery Center is proud to offer their patients the most up-to-date skin care services available. Whether you wish to change and refine your appearance or reduce the effects of aging, the decision to undergo any cosmetic medical treatment deserves careful consideration. Because of the wide variety of options available, it is now more important than ever to seek out highly trained and qualified cosmetic plastic surgeons to achieve your safest and most natural results. Dr. Brent Moelleken M.D., F.A.C.S., and his professional staff offers you the expertise you need to make the right cosmetic enhancement decisions. Dr. Moelleken is a skin care expert who has training and experience with a variety of skin revitalizing and resurfacing treatments and in some cases, a combination of treatments and techniques, rather than one single method, may yield the best results.

Dr. Moelleken is a plastic, reconstructive, and cosmetic surgeon with offices in Beverly Hills and Santa Barbara, California. He is double board certified by the American Board of Surgery and American Board of Plastic Surgery and specializes in cosmetic surgery. He received his premedical, medical, and surgical training at Harvard University, Yale University, UCSF and UCLA. He has innovated numerous procedures, including LiveFill®, the USIC® and LUSIC® cheeklifts, the 360 Facelift® to restore harmonious youth and beauty to the face, and the Hybrid tummy tuck®, a short incision tummy tuck procedure. He is one of three specialty-trained surgeons in the world to complete the yearlong Aesthetic Surgery Fellowship at UCLA. He has the prestigious FACS degree and is a member of the American Society of Plastic Surgeons (ASPS), The American Society for Aesthetic Plastic Surgery (ASAPS), Who’s Who in the World and numerous medical and scientific organizations. He has been selected by Who’s Who in America’s Top Plastic Surgeons in Los Angeles, Ciudad’s Top Doctors in Los Angeles, and by Vogue Magazine as one of the Top 10 Plastic Surgeons in America.
Dr. Moelleken offers a full array of the most advanced and cutting edge cosmetic surgical techniques ranging from minimally invasive procedures to extreme makeover surgeries. Dr. Moelleken will take the time to fully explain your options and tailor an individualized and unique treatment plan specifically for you. Dr. Moelleken understands that beauty is more than skin deep but that does not mean your skin should not be as youthful and healthy looking as possible. That is why Neo Surgery Center offers so many choices for your skin repair and maintenance and all of them focus on improving your skin’s health. If you want to minimize wrinkles, treat blemishes, or correct or prevent sun damage, these goals can be attained. Dr. Moelleken combines an artful eye and refined skills to create natural looking results. Rediscover your youth in a warm, safe, and comfortable environment at Neo Surgery Center where we specialize in giving you the best care to refresh and rejuvenate your appearance through comprehensive skin care services.

Skin Anatomy
The skin is made up of three layers: the epidermis, dermis, and the subcutaneous tissue.

Epidermis
The epidermis is the outer layer and functions as a barrier to the external environment. The cells of the epidermis, keratinocytes, move from the bottom layer of the epidermis to the top layer building up a large amount of keratin and developing a tough outer shell. Once these cells reach the top layer, they flake off. If this process becomes abnormal the skin can look scaly.

There are four major layers of keratinocytes (the structural cells) in the epidermis and one layer that is present only in certain parts of the body.

  • The bottom layer, the stratum basale, has cells that are shaped like columns. In this layer the cells divide and push already formed cells into higher layers. As cells move into the higher layers, they flatten and eventually die. This layer contains just one row of undifferentiated columnar stem cells and half of the cells differentiate and move to the next layer to begin the maturation process. The other half stays in the basal layer and divide over and over again to replenish the basal layer. The stratum basale is responsible for constantly renewing epidermal cells.
  • Cells that move into the spinosum layer (also called prickle cell layer) change from being columnar to polygonal. In this layer, the cells start to synthesize keratin.
  • The cells in the stratum granulosum, or granular layer, have lost their nuclei and are characterized by dark clumps of cytoplasmic material. There is a lot of activity in this layer as keratin proteins and waterproofing lipids are being produced and organized.
  • The stratum lucidum layer is only present in thick skin where it helps reduce friction and shear forces between the stratum corneum and stratum granulosum.
  • The cells in the stratum corneum layer are known as corneocytes. The cells in this layer have flattened out and are composed mainly of keratin protein, which provides strength to the layer but also allows the absorption of water. The structure of the stratum corneum layer looks simple but this layer is responsible for maintaining the integrity and hydration of the skin. There are actually complex processes that are at work in the stratum corneum and minimal disruptions of any of these processes can cause a variety of skin problems.

Dermis
The second layer of skin is the dermis, which contains the structural elements of the skin, the connective tissue. There are various types of connective tissue with different functions. Collagen gives your skin its strength, proteins called glycosaminoglycans give your skin its turgor, and elastin fibers give your skin its elasticity or spring.

Dermal-Epidermal Junction
The junction between the dermis and the epidermis is an important structure. The dermal-epidermal junction interlocks forming fingerlike projections called rete ridges. The cells of the epidermis receive their nutrients from the blood vessels in the dermis. The rete ridges increase the surface area of the epidermis that is exposed to these blood vessels and the needed nutrients.

Subcutaneous Tissue
The bottom layer of skin is the subcutaneous tissue containing fat cells. These fat cells provide insulation to the body and make the skin look plump or full.

Causes of Aging and Wrinkles

  • As you age, your epidermal cells become thinner and less sticky. The thinner cells make your skin look noticeably thinner as well and the decreased stickiness of the cells decreases the effectiveness of the barrier function allowing moisture to be released instead of being kept in the skin. This causes dryness and the number of epidermal cells decreases by 10% per decade. As they divide more slowly and you age, your skin is less able to repair itself quickly.
  • The effects of aging on the dermal layer are significant. Not only does the dermal layer thin, but also less collagen is produced and the elastin fibers that provide elasticity wear out. The changes in the scaffolding of the skin cause your skin to wrinkle and sag. Also, sebaceous glands get larger but produce less sebum and the number of sweat glands decreases. Both of these changes lead to skin dryness.
  • The rete-ridges of the dermal-epidermal junction flatten out, making the skin more fragile and easier for the skin to shear. This process also decreases the amount of nutrients available to your epidermis by decreasing the surface area in contact with the dermis, which affects your skin’s normal repair process.
  • In the subcutaneous layer, the fat cells get smaller with age. This leads to more noticeable wrinkles and sagging, as the fat cells cannot “fill in” the damage from the other layers.
  • Exposure to ultraviolet light, UVA or UVB, from sunlight accounts for 90% of the symptoms of premature skin aging and most of the photoaging effects occur by age 20. The amount of damage to your skin caused by the sun is determined by the total lifetime amount of radiation exposure and your pigment protection. Changes in your epidermis caused by the sun include thinning of the epidermis and the growth of skin lesions such as actinic keratoses, basal cell carcinomas, and squamous cell carcinomas. In your dermis, sun effects cause collagen to break down at a higher rate than with just chronologic aging. Sunlight damages collagen fibers and causes the accumulation of abnormal elastin. When this sun-induced elastin accumulates, enzymes called metalloproteinases are produced in large quantities. Normally, metalloproteinases remodel sun-injured skin by manufacturing and reforming collagen. However, this process does not always work well and some of the metalloproteinases actually break down collagen. This results in the formation of disorganized collagen fibers, known as solar scars. When your skin repeats this imperfect rebuilding process over and over, wrinkles eventually develop.
  • Free radicals are unstable oxygen molecules that have only one electron instead of two. Because electrons are found in pairs, the molecule must scavenge other molecules for another electron. When the second molecule looses its electron to the first molecule, it must then find another electron repeating the process. This process can damage cell function and alter genetic material. Free radical damage causes wrinkles by activating the metalloproteinases that break down collagen. There are several factors that start this cascading process including exposure to even small amounts of UV radiation in sunlight, smoking, and exposure to air pollution.
  • It is likely that you will experience skin changes as a result of the hormonal effects of menopause or decreased estrogen production. However, studies in humans have not documented which skin changes are specific to decreased estrogen and which skin changes are results of sun exposure or just normal chronological aging.
  • Habitual facial expressions cause your skin to wrinkle as it looses elasticity. Frown lines between the eyebrows and crows feet radiating from the corners of your eyes develop as the tiny muscles in those areas permanently contract.
  • The effects of gravity make the loosening of your skin more apparent as skin sags, which causes jowls and drooping eyelids.

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