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Q&A with Lisa Williams, ANP-C, Nurse Practitioner

Q: Hi Lisa, I am 45 year old female. I have been exercising for years in the gym as well as running almost 5 miles a day at least five days a week. I also ride my bike and hike frequently. I have low body fat and an athletic build and many people mistake me for a teenager from the behind but once I turn around they can see that is not the case! Recently, I notice in my photos that I am gaunt looking and look skeleton like in the face. Lately, I have lost a lot of fat in my face. I apply many creams and sunscreen to my face but it is not improving. I love to run and work out and am not willing to discontinue my strict exercise regimen just so I can save my face! I have always been considered good looking but hardly anyone complements me anymore. I heard you can prevent my face from looking older as well as turn back the clock. Any advice?

A:  Congratulations on your successful lifestyle so far. Believe it or not, your question is a lot more common than you might think. A lot more body fat is stored in the face than most people realize (until they compare before and after photos or hear comments from others). But not to worry, because there is a solution. You do not have to choose between a fit body or a youthful face. You can have both. We all know that those leaner looking people who are typically runner’s, hikers, triathletes, yoga buffs, and those who enjoy road bike action can develop a skinny looking face with hollow cheeks. Additionally, the lifelong accumulation of sun damage further damages the loss of the fatty layer beneath the skin. This is commonly referred to as the classic “Runner’s face”.

Runner’s face typically occurs in both men and women ages 35+ who exercise to improve their body, and in doing so end up with a skeletal and bony face. When exercising, an athlete burns off fat beneath the layers of his/her skin. The marked loss of fatty tissue results in a loss of volume which leads to a prominent appearance of the bones, accelerated development of skin laxity and deepening of wrinkles. Though you may look like a 20-year-old from the chest down or from the behind, your face will easily give away your age. The general consensus is that the leaner we are, the less fat we have in our face. At the same time, as we age we lose facial volume. So losing weight or becoming very lean (like many runners are) can cause the face to look significantly older. It is difficult for people who have always been considered attractive to suddenly personally notice that their skin is frail, thin skinned, bruises more easily, sagging and not to mention that aging is causing some emotional distress. My opinion is that the most over looked sign of aging is loss of volume in the mid face. As we age, the mid face lose fat and begins to narrow, shifting the face downward making the mid face appear bony. Volume loss here contributes to the appearance of drooping and sagging of the cheeks and eyes. It begins as early as in your 20’s. It is most notable in athletes who have very little fat on their bodies, I’ve found it especially in runners.

Q: What are my non-surgical options? I do not want to undergo facial plastic surgery at this point in time.

A: There is a new product on the market. Juvederm® Voluma® is the only hyaluronic acid filler approved for use in the mid-face. We at Ultra Smooth Skin offer Juvederm® Voluma® here at the Village. Juvederm® Voluma® is a thick injectable hyaluronic acid volumizer that re-contours the face to restore volume to the cheeks, cheekbone, nasalabial folds, mouth corners and jaw line. Results are instant, revealing a subtle yet natural aesthetic lift and result, recreating the “triangle of beauty”. It is a thicker than regular Juvederm® and recently FDA approved up to two years
for longevity. It’s just not my preference, but for extreme volume loss I can see it
being more cost effective.

Q: What about my neck? Can you do something about my neck?

A: It is difficult to treat the neck. We do not inject fillers in the neck. Some fight neck laxity and damage by doing the Fraxel and Thermage. Otherwise, another option is to get a neck lift by a board certified plastic surgeon.

Q: Should I stop working out so much and will that save my face?

A: Absolutely never stop working out and doing what you love. I’ve never told someone to stop running so they could look younger, it is so easy to plump a gaunt face right back up by injecting a little Voluma®.

Q: How do I know if I am a good candidate? I do not expect a miracle and do not expect my face to look like it did when I was 20, just an enhancement or a diminishment of some laxity and loose skin.

A: We can assess you and determine if you are a good candidate and give you a fair analysis. That is wonderful that you have realistic expectations. We do not want to treat anyone that is not realistic. We cannot make someone look like they did 20 years ago, but certainly it is possible turn back the clock 5-8 years and most importantly we can provide maintenance. It is acceptable to have a few wrinkles at some point, and those lines won’t diminish your beauty. Want proof? Look at Catherine Deneuve and Kate Moss.

Q: How many syringes will I need?

A: It is difficult to determine but most people start out with one or two syringes of Voluma® and then we periodically assess you every 6 months.

Q: Can I get Voluma® in the other areas like my lips or the lower face?

A: No, Voluma® is only FDA approved for the mid face. We can though place Juvederm® XC in the lower face and lips as long as you are natural looking already in those areas. We do not inject in people that have done other procedures and have too much product in their face or lips already.

Q: How many injections have you performed?

A: I have performed thousands of cheek and mid face injections. We are one of the top
purchaser’s in the country for Botox® and Juvederm®. Ultra Smooth Skin has earned a “Black Diamond” certification from Allergan, the makers of Botox® and Juvederm®. It’s awarded to leaders in the medical aesthetics field, and demonstrates a commitment to the highest level of patient care. Less than 1% of all medical aesthetic practices ever reach this status. Additionally, I completed the de Maio Master’s Voluma® Technique Course taught by the wonderful Mauricio de Maio, MD, Sao Paulo, Brazil, a renowned plastic surgeon and expert Voluma® pioneer injector. I was privileged to be included as one of a few nationwide facial filler injectors to be recently trained by Dr. de Maio.

Lisa Williams, ANP-C, Nurse Practitioner at Ultra Smooth Skin is located in the Gainey Village Health Club & Spa and the DC Ranch Village Health Club & Spa.

To make an appointment please call 480-582-0803 and be sure to ask about the Village member discount.

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