A wide range of treatments allows us to continue looking our best as we move into mid-life. We all want to age gracefully, moving seamlessly and beautifully into our future selves. As we approach midlife, there are various treatments we can turn to for a little help to slow down the aging process. Dr. Philip Solomon MD, FRCSC, Otolaryngology, Head and Neck Surgeon, practicing Facial Plastic Surgery in Toronto, discusses some of the treatments and tools that can help along the way.

By Dr. Philip Solomon & Nancie Heiber


Living Luxe: Dr. Solomon, the wide choice of treatments available can be overwhelming. How can we decide which treatment is best for our needs?

The first step is to meet with the patient to learn about their goals. They often discuss what bothers them, what they looked like when they were younger, what has changed and what they want to enhance. If they are looking for non-surgical options, we have a variety of tools we can recommend, depending on their concerns. Being a facial plastic surgery clinic, we have the luxury of offering both surgical and nonsurgical options, and the ability to combine them when necessary. We always start with the least invasive option as well as educate the patient about all procedures we offer that they may benefit from.


Living Luxe: What are injectables and how are they used?

Injectable fillers are one of the commonest aesthetic treatments worldwide. These dermal fillers consist of hyaluronic acid and are used to add volume to areas where volume loss is visible. Treatment sites include cheeks, tear troughs, temples, nasolabial folds and lips. Volume loss starts becoming visible in our 30s as collagen production slows down; imagine a balloon as it starts to lose air. Our face starts to look depleted. We also off er injectable aesthetic treatments to stimulate the production of collagen to improve skin quality , giving it more density to help minimize fine lines and folds. These treatments have become more mainstream and include PRP (platelet-rich plasma), hyaluronic acid skin boosters, Sculptra and semi-permanent filler. In a separate category, neurotoxin addresses the top third of the face by relaxing the facial muscles to minimize the appearance of wrinkles, fine lines and crows’ feet.


Living Luxe: Tell us about energy devices. What are they? How are they used? What kinds of results do they yield?

Energy devices refer to technology that can deliver a cosmetic treatment using radio-frequency, carbon dioxide, erbium, light therapy, ultrasound therapy or pico laser. Each delivery system targets the skin and skin concerns uniquely. Some energy devices address multiple issues, while others are excellent at targeting one particular issue. For example, pico laser addresses pigment such as sun damage, freckles— any brown pigment on the skin. IPL, also known as broadband therapy, treats red indications such as broken capillaries. CO2 laser can address pigment as well as texture, tone and fine lines, while also providing skin tightening. In some cases, we combine energy devices to best address a skin concern. Results vary from patient to patient. We can’t always pre-determine the outcome. In some cases, we can achieve a great result with one treatment, and in other cases multiple treatments may be required. It depends on how the patient’s skin responds to the treatment.


Living Luxe: What are threads? How are they used?

Threads have been around since the 1990s. However, the material and techniques have evolved over the years. Threads have been sought out as a “mini-lift ” without surgery, but I wouldn’t say the results are comparable. Thread lifts can be performed in-office by a registered nurse or physician. They are designed to lift the tissue beneath the skin providing a “tightening and lift ing” effect. Threads also help with the production of collagen in the treatment site, which translates into improved skin quality and volume. This treatment is more invasive than dermal filler and far less invasive than a facelift .


Living Luxe: How do you decide if surgery is a better option for one of your patients?

In most cases, it’s quite apparent when surgery is the better option. What we don’t want to do is send patients down a non-surgical path that is time-consuming and can be costly, and not deliver the results they are hoping for. It’s important that we understand the patient’s goals, discuss all options for treatment and then decide which path is best to achieve their goals. If we see a woman in her mid-to-late 50s who has skin laxity , we can offer energy devices. However, if there is significant skin laxity that would be better addressed with surgery, we would give our patients both options, educate them on the procedures and projected outcome, and let them choose the best option for themselves.