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Beauty Adventure: Microneedling

Recently, my daughter met one of my cousins for the first time and commented, “She looks about 80.” Normally, this wouldn’t be a compliment, but my cousin is nearly 95!

One reason Helen looks so good is that she’s always taken care of her skin. In my own quest to keep blotches and wrinkles under control without going overboard, I keep exploring non-invasive procedures that deliver visible results to supplement my small arsenal of lotions, potions and sun block.

Which led me to the SkinPen.FullSizeRender 13

Let me say at the outset that there are devices such as the Derma Roller you can use at home, and they seem to do a nice job of making the skin glow. However, they don’t penetrate as deeply as tools used by professionals so are less effective at treating fine lines.

The idea behind microneedling is to create thousands of micro-injuries (tiny vertical channels in the dermis) to initiate the body’s wound healing process. It sounds scary but is actually pretty cool, as the body responds by breaking down underlying damaged tissue and producing healthy new cells. These repair the injured tissue, creating more collagen and elastin.FullSizeRender 14

As a side note, Fraxel will do the same thing, although it’s more aggressive.

Lasers, chemical peels and other invasive methods are considered ablative, meaning that they remove tissue to start collagen production in your skin. Lasers such as Fraxel or CO2 fractional laser either remove the top layers of skin or remove only small parts/fractions of the skin. Your skin care professional will know what’s best for your particular situation.

Both microneedling and lasers result in collagen production that slowly continues months after treatment, but the lasers remove tissue. Microneedling creates micro-injuries without using heat and without removing layers of skin, so the skin heals more rapidly compared to the recovery time from lasers. It’s also much less prone to infection.

Sign me up.

Microneedling is a two-step process. During the 28-day remodeling period following treatment, specific nutrients such as Vitamins C, A, E and copper peptides are applied topically to ensure proper cell nutrition. The makers of SkinPen offer a full line of post-procedure products (surprise!) or ask your derm or facialist for other suggestions.

Stephanie, my skin whisperer, recommends a series of three treatments spaced a minimum of one month apart. I can continue treatments indefinitely if the budget allows; she has one well-heeled client who comes in every six weeks but at a couple hundred a pop that’s out of my league.

Here’s what the makers of SkinPen say:

  • A procedure that helps to reduce the appearance of fine lines and smooth wrinkles, SkinPen® may be used on all skin types
  • A safe solution with little recovery time
  • Results from a minimally invasive procedure
  • A procedure for ongoing maintenance of healthy skin
  • The advantages of your SkinPen® microneedling procedure include:
    • SkinPen® microneedling is minimally invasive and a quick procedure, performed in-office
    • Little recovery downtime makes SkinPen® ideal for a busy lifestyle, and a great place to start for aesthetic procedures
    • Support of healthy skin
    • Skinfuse® post-procedure protocol by Bellus Medical ensures you receive all the right vitamins and minerals to your skin, with none of the wrong ingredients
    • Results are generated from your own skin’s natural collagen remodeling and elastin
    • SkinPen® may be used on all skin types
    • Ideal for assisting in reducing the signs of aging
    • A versatile, precision design for use on most all parts of the body including face, neck, and décolletage. The SkinPen® helps reduce fine lines and soften the signs of aging. By tightening pores, your skin will look refreshed and have a youthful glow!

It’s now about 3 months since my first treatment and the lines around my lips do seem to have diminished. It will probably take another 3 months to see the true results.

TREATMENT #1

First, Stephanie applies a numbing cream and I wait 20 minutes for it to take effect. Perfect time to catch up on the office’s trashy celeb magazines! Using a gel for glide, she moves the little machine (which indeed looks like a pen) all over, avoiding moles. She goes over the worst areas (around mouth, chin) a couple of times. The SkinPen makes a fairly loud buzzing noise and doesn’t hurt, except for some slight pain in my lip and forehead areas. It certainly hurts a lot less than the IPL (Intense Pulsed Light) facials I get twice a year to zap brown spots. She then applies the company’s SkinFuse Rescue to protect the skin and begin restoring its moisture barrier. I leave with a tube of Rescue to use twice a day (or more as needed), a weekly collagen booster (Surge) and post-procedure instructions.  FullSizeRender 12

  • Day Of: After microneedling my face is dry, shiny, tight and blotchy, as if I have a sunburn. I go straight home, hoping I don’t run into anyone I know. The redness fades a bit after a few hours and I don’t look quite as horrible though it feels rather uncomfortable. Tonight I’m instructed to rinse my face with water only and apply Rescue cream before bed. I notice that the Rescue peels a bit (I’ve now applied it a few times) and resist the urge to poke at it.
  • Day 1: After 24 hours I use a mild cleanser, apply moisturizer and avoid the sun. Most of the redness has faded but my skin still feels very dry, tight and dehydrated. I have a few areas of tiny pinprick blood spots on my cheeks and apply some topical arnica. I would NOT want to socialize with my skin looking like this!
  • Day 2: Better but still dry. I continue putting arnica on the pinpricks.
  • Day 3: Much more hydrated. Pinpricks are fading. Using normal skincare products. By today I could go out in public wearing tinted sunblock.
  • Day 4-6: My skin now feels normal; I can cover the pinpricks with makeup.
  • Day 7 and once a week: Use the Surge collagen booster. IMG_1861

TREATMENT #2 (5 weeks later)

  • Day Of: After I comment that I haven’t seen any improvement yet, Stephanie suggests using PRP (Platelet Rich Plasma; also known as the “vampire facial”). PRP involves extracting a small amount of a patient’s blood from their arm and spinning it in a centrifuge to separate the plasma – the fluid part – from the red and white blood cells. Sounds creepy but is supposed to speed healing. Hey, why not?
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Bwaahaha!

Stephanie is more aggressive with the SkinPen than last time but only my lip area is briefly painful. The plasma drips more than the gel so it’s messier but it only stains the headband she’d applied. After treatment Stephanie uses a new product from Alastin. Their recovery product is a whopping $195 for 1 ounce so, guess what, I don’t buy it.

At home I do some online research and find that the company (founded by 2 guys who used to work for SkinMedica) doesn’t disclose much about their ingredients or amounts so reviewers are skeptical. The products are meant to produce both elastin (hence the name) and collagen but doctors question how much a topical can really do. I’ve also read that it’s difficult to regenerate elastin in mid-to-older skin. Before I spring for the big bucks I’d want to learn a whole lot more.

  • Day 1 (24 hrs later): The redness is fading and my skin is taut but less so than the first time. I have fewer pinpricks but in the same (left cheek) area. Apply arnica.
  • Day 2: Notably more hydrated. My skin is too blotchy to go out in public without makeup (I use tinted Elta MD sunblock) and there’s some peeling from the products but it feels way better.
  • Day 3: Almost 100% normal. Still applying arnica to red spots and using normal skincare.
  • Day 4: Totally healed and my skin feels hydrated and supple. I’ve added Elta MD Barrier Cream to my skincare ritual (as of Day 1 night), which may be helping.
  • Day 8: Add Surge to my nighttime ritual (and will continue to use once a week).

TREATMENT #3 (after 4 weeks)

  • Day Of: PRP again. Nurse draws blood and spins to extract platelets. The SkinPen is painful around my lips, ok on my forehead/neck. I notice more redness/blotchiness/ blood spots than the previous two sessions. Stephanie applies Alastin and Rescue before I leave.
  • Day 1: Today the redness is like a fading sunburn and my skin is taut. I only need Rescue twice (afternoon and at night). I apply arnica to blood spots (left cheek), take oral arnica 3x and add Elta barrier cream to my night ritual.
  • Day 2: I use a hyaluronic acid mask, which adds moisture, and I can go out in public if I cover spots with Elta tinted sunblock. My skin feels slightly dryer than normal but not taut. I add vitamin C to my daytime ritual after applying Rescue.
  • Day 3: Back to normal. I still have faint red spots on my left cheek and continue to use arnica.
  • Day 7: Spots are finally gone.

One final note: The less you’ve cared for your skin, the more dramatic the results will be. If you’ve been diligent about sun block and retinol or use professional-level skin care products with good concentrations of vitamin C, glycolic acid, hyaluronic acid etc., the results will be more subtle: smoother skin, less blotchiness and a softening of fine lines.

So far, I think it’s worth it.

(Note: Not a sponsored post — I wish!; sunrise image from Pixabay.com)

Am I What I Wear?

Lately, I’ve been going through an identity crisis. A sartorial one, primarily, stemming from the question, “Who am I if I’m not working?” combined with the dread of becoming invisible with the passing years.

As a freelance writer/retired (mostly) by choice, I could spend the day in ratty sweatpants and no one would notice. But that’s just not “me”; I worked in an office for 30 years and dressing for work is a difficult habit to overcome. Plus, I’ve always loved fashion.

This particular crise du jour is also accompanied by weight loss, which would normally be cause for celebration but is in fact cause for alarm/introspection/analysis as I have to decide: Since I have to buy new clothes that fit, WHAT should they be?

The delightful blogger Lady Sarah offers a brilliant suggestion: Create a pie chart for how you actually spend your time so that you can buy accordingly. Instead of shopping for a fantasy life, I’m taking this a step further to analyze not just how I currently spend my time but how I’d like to spend it.

Categories

• At home doing chores, scrolling through online articles, contemplating working out, watching TV, contemplating cleaning, actually working out, reading, actually cleaning

• At home writing (want to project a professional image, if only to myself)

• Running errands: Stained tees are a non-starter even though the chances of bumping into someone I know — since I know virtually no one in Texas — are slim to none

• Lunch dates: All too few. Goal: expand opportunities

• Dinner dates with husband and friends: Ah, safe ground here. Need to look nice but not overly fussed over

• Opera/Symphony: Unlikely to run into anyone here either but a good excuse to dress up

• Entertaining at home: What to wear that is chic but won’t get stained while cooking?

• Travel: My sweet spot, wardrobe-wise. I’m a big-city girl at heart and enjoy being able to wear my favorite pieces without feeling overdressed. Not that anyone’s looking – but it’s all about how you see yourself, isn’t it?

• Playing with grandchildren: Not the time for a silk blouse, but surely I can do better than an old band t-shirt and leggings even if the baby is likely to spit up

• Summer hiking/walking: Anything goes, as long as it’s waterproof

• Wine tasting (a favorite summer activity): Upgraded casual, mostly dark colors in case I spill something – a real possibility around Glass #3

FullSizeRender 7All in all, what I’ve learned from this exercise is that I shouldn’t buy another leather jacket since I live in a warm climate (much as I adore them) and that I should create more opportunities that are appropriate for my favorite items rather than “dumbing down” my wardrobe to match my mostly-stay-at-home activities.

Sign me up for: adult education classes, more travel, more lunches/dinners with friends, more evenings out, volunteering at anything where you shouldn’t look like a slob, and so on.

Anyone else having an identity crisis as you change jobs, become a stay-at-home parent or approach retirement? Please share your solutions and insights with the rest of us!

Xx, Alisa

A Family By Any Other Name

If you’re like me, the concept of “family” is complicated. The family we’re born into may be less than ideal, incorporating fraught relationships with parents or siblings. Even in families with a relatively healthy dynamic, there’s often a tendency to act or be treated as if we are eternally eight years old.

As we get older, our definition of family expands and changes. Lines blur as our children become friends, close friends become more like siblings, and siblings may become strangers.

Since Thanksgiving is a holiday that’s typically associated with family, let’s celebrate ALL our families, not just our biological ones:

  • Circumstantial: The family we join through marriage or re-marriage
  • Work: After all, we probably spend at least as much time with our “work family” as we do at home
  • Friends: Who else could we bitch to about everything — including our families?!
  • Support System: Our family of stylists, massage therapists, manicurists etc., with whom we share stories and confidences
  • Our church, synagogue, mosque or other religious affiliation
  • Neighbors

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This is one of my favorite recipes for dessert, whether you’re hosting or bringing something to the feast. Almond flour and Whey Low make it healthier.

Happy Thanksgiving, everyone — however (and with whomever) you spend it!

Double Chocolate Almond Flour Brownies

Ingredients

  • 1/2 cup unsalted butter (I use 4 tablespoons (¼ c) butter + ¼ c canola oil)
  • 1 cup semisweet chocolate chips (substitute bittersweet if you prefer less sweetness)
  • 1 cup almond flour
  • 3 tablespoons unsweetened cocoa powder
  • 1/2 teaspoon baking powder
  • 1 teaspoon kosher salt
  • 3 eggs
  • 1 cup sugar (I use 1/3 c brown + 1/3 c white for less sweetness)
  • 2 teaspoons pure vanilla extract
  • Optional: ¼ teaspoon espresso powder

Instructions

  1. Preheat the oven to 350º and butter an 8”x8” pan.
  2. Place the butter and chocolate chips in the top of a double boiler or a large glass bowl set over a pot of gently boiling water. Whisk together until the butter and chocolate are melted and well combined. Set aside and let cool for five minutes.
  3. In a large bowl, mix the almond flour, cocoa powder, baking powder and salt. In a separate bowl, whisk together the eggs, sugar and vanilla.
  4. Add the cooled chocolate and butter mixture to the egg/sugar mixture. Whisk to combine and then mix into the dry ingredients until everything is well blended.
  5. Pour the batter into the baking pan and bake for 25 minutes or until tester comes out clean with a few crumbs clinging to it.
  6. Cool before slicing.

The Bunion Diaries – First Month

Now that I’m at one month post-surgery, I can tell anyone who’s contemplating a bunionectomy what to expect. Warning: gnarly photos ahead; not for the squeamish (this means you, dear husband)!!

Day of surgery 

We arrive at the facility at 7 a.m., where the TV in the waiting room is endlessly replaying recaps of last night’s endless presidential debate at top volume. This is one time I would give anything for Keeping Up with the Kardashians or any of the Real Housewives.

I’m prepped, changed into a gigantic dressing gown and stuck with IVs and other stuff to measure my vital signs. My blood pressure is very low (100/70) so I am either actually relaxed or a zombie, not sure. Luckily, hearing Trump did not spike my BP to lasting effect.

We talk to the anesthesiologist, who is extremely thorough and asks detailed questions nobody else has. I see my doc and it’s off to dreamland from about 9 to 12, when I emerge in the usual post-surgical fog. (Note: they use a general anesthetic since they literally don’t want you to move a muscle.)

Here’s my “before” photo. Pretty ugly, I know. That’s why I’m here.

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Once home, I settle into bed with the following:

  • Wedge pillow plus another old pillow under leg to keep elevated (also brought to surgical center for the ride home)
  • Computer and cell phone
  • Glass of 7:1 water/orange juice to stay hydrated
  • Meds and saltines to avert opiate-related nausea
  • Stack of magazines and book (the latest from the excellent Alan Furst)
  • Rented knee roll-about scooter (mine’s a nice shiny red) and crutches for tomorrow.  img_1567

Today’s about resting, following multiple instruction sheets, eating mild food and sleeping. Lots of sleeping.

Day 2

No pain yet so nerve block must still be working. I take pain meds prophylactically every four hours to avoid it though. My main job is to alternate ice on/off every 30 minutes and keep moving my legs and rotating my ankle to prevent blood clots.

I’m not at all hungry until dinnertime, and still in a drug fog most of day. My poor husband has to do all cooking/cleanup/etc. and it’s going to be a long slog until I can contribute.

Day 5

My foot is bandaged like The Mummy, and just about as shapeless.

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I’m now taking ibuprofen only if needed. The pain block (Exparel) lasted 4 days and is a bona fide miracle drug.  Getting around on the scooter is quite a production. It doesn’t have much of a turning radius and I have to keep locking the brake so it won’t slip. Once locked in position, it gives me a secure place to rest my leg.

Crutches require upper body strength so I’m lifting hand weights to help. I can touch down with my operative foot (partial weight is ok) which is better than hopping. But it’s a pretty exhausting way to get around.

I’m officially allowed to shower, which is a multi-step process beginning by removing my safety shoe and encasing my foot in a knee-high plastic bag that looks like a giant condom.

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Funny, I never noticed before how high the “lip” of the shower is; trying to get over it with one leg is quite a challenge. My DH (dear husband) helps lift me in; once in, I’m fine. His back, not so much. We don’t attempt this again– back to sponge baths!

Day 6

My heel and the sole of my foot are quite bruised. I resume taking oral arnica, which I stopped a few days ago, and start applying topical arnica too. Hope this helps.

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First post-op visit

It’s 8 days after surgery. DH drives me and the scooter over to the doctor’s office. His nurse removes the bandages. The top of my foot is swollen and my toes look like fat little sausages. She tells me that swelling can take 6 months to a year to fully resolve. Oh joy. The incision is about 3″ long and is healing well but I can’t transition to a walking boot yet; the bone a little softer than ideal for full weight-bearing so I’ll have to wait and hopefully get the boot next week.

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Week 1: Who are you and what have you done with my ankles?!

I bump up my calcium intake to 600 mg twice a day, having slacked off to once a day during the previous month. (Note to those of you anticipating having this procedure: Make sure to increase weight bearing exercise and check your vitamin D levels well before surgery since vitamin D is needed for calcium absorption.)

Pain is low level but I experience occasional throbbing. Ibuprofen at normal levels (a 200 mg tablet every 4-6 hrs as needed) is helpful. Sleep is more challenging.

By now I have mastered the multi-step shower dance: first, DH places a chair outside the shower so I can use the chair back as support. I ease in and sit on the shower bench and then DH moves the chair so the door can close. You do not want to be in a rush for this one!  If my shower didn’t have a built-in seat this would not work, since I can’t balance on my left heel for the time it takes to shower and do my hair. Best plan is to alternate with sponge bathing for now.

2nd Post Op Visit

Big disappointment at Week Two:  Although everything is healing well, my nice doctor wants me to stay off my foot for another two weeks to be on the safe side. We do not want the pins in there shifting around. Ergo, still stuck with the scooter. On the plus side, my triceps are tightening up from lifting and repositioning the damn thing every few minutes.  And since the incision is almost fully healed, except for a couple of steri strips, I have a new cleaning option (sans giant leg condom): the tub!

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Week 2

This is way easier: position the scooter next to the tub, step in with my good leg, then lower the other one, making sure not to step down. All good.

Weeks 3 & 4

Continue to heal, no pain although bruised areas are still sore, and finally when I see my doctor at Week 4 he lets me transition to a walking boot. It’s very space-age, with a pump to inflate and deflate pressure. Unfortunately, the sole of the boot is 2″ higher than my regular shoe, so I am listing like a drunken sailor. But, I’m ambulatory! BTW, you can order a sort of platform thingy from Amazon called EvenUp. It looks a bit like a snowshoe and adds 1/2″-3/4″ height to your normal shoe or sneaker. My hiking boot is almost the right height so I’m not too uneven for the two days I wait for Amazon delivery.

Week 4

My tasks at home are to exercise the toe by bending it forwards and backwards (ouch) to keep it flexible (3 sets of 10 reps, twice a day) and to cover the scar with ScarAway, a silicone patch you cut to whatever size you need to help prevent and flatten the incision. So far, I’ve taken four baths and it hasn’t budged.

Wrap-up

After 4 weeks I’m still swollen around the ankles as well as the ball and top of my foot (an ace bandage leaves indentations) but I can already see improvement. Best of all, I’m now cleared to drive so I feel much more independent.  Come spring, I might even splurge on some Jimmy Choos!