Approach to the Mature Cosmetic Patient: Aging Gracefully

June 2017 | Volume 16 | Issue 6 | Supplement Individual Articles | 84 | Copyright © June 2017

Susan Weinkle MDa,b and Michael Saco MDa

aUniversity of South Florida Department of Dermatology & Cutaneous Surgery, Tampa, FL bCosmetic Dermatologist and Mohs Surgeon, Bradenton, FL

Figure5Figure6Ultimately, any procedure where insertion of a needle or cannula is required can result in bruising. Patients using over-the-counter products like glycerin, evening primrose, and vitamin C can have a greater risk of bruising. In contrast, arnica and bromelain can help decrease the likelihood of postprocedure bruising.11,12 Overall, as our population continues to age, the demand for minimally invasive aesthetic procedures continues to increase. Various changes happen as people age, which can be combatted using laser and light devices, neuromodulators, soft tissue fillers, and some of the newer treatment modalities, including PLGA suspension sutures, deoxycholic acid, and radiofrequency energy devices. Ultimately, it is up to dermatologists to master these and future aesthetic procedures in order to give a whole new meaning to aging gracefully.


Dr. Weinkle is a Medical Consultant, Allergan; Clinical Investigator, Allergan; Medical Consultant, DermAvance; Clinical Investigator, DermAvance; Medical Consultant, Galderma; Clinical Investigator, Galderma; Medical Consultant, Merz; Medical Consultant, Procter and Gamble; Medical Consultant, Kythera; Clinical Investigator, Kythera; Medical Consultant, Myoscience; Medical Consultant, Teoxane; Clinical Investigator, Teoxane; Medical Consultant, Sinclair; Clinical Investigator, Alphaeon. Dr. Saco has no conflicts of interest to declare.


  1. Mayoral FA, Kenner JR, Draelos ZD. The skin health and beauty pyramid: a clinically based guide to selecting topical skincare products. J Drugs Dermatol. 2014;13:414-421. 
  2. Lupo M, Jacob L. Cosmeceuticals used in conjunction with laser resurfacing. Semin Cutan Med Surg. 2011;30:156-162. 
  3. Weiss RA, Weiss MA. Evaluation of a novel anti-aging topical formulation containing cycloastragenol, growth factors, peptides, and antioxidants. J Drugs Dermatol. 2014;13:1135-1139. 
  4. Wisniewski JD, Ellis DL, Lupo MP. Facial rejuvenation: combining cosmeceuticals with cosmetic procedures. Cutis. 2014;94:122-126. 
  5. Rohrich RJ, Pessa JE. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery. Plast Reconstr Surg. 2007;119:2219-2227; discussion 2228-2231. 
  6. Fenske NA, Lober CW. Structural and functional changes of normal aging skin. J Am Acad Dermatol. 1986;15:571-585. 
  7. Weinkle S. Facial assessments: identifying the suitable pathway to facial rejuvenation. J Eur Acad Dermatol Venereol. 2006;20 Suppl 1:7-11. 
  8. Levin J, Momin SB. How much do we really know about our favorite cosmeceutical ingredients? J Clin Aesthet Dermatol. 2010;3:22-41. 
  9. Sadick NS. Device-assisted transepidermal delivery of cosmeceuticals: a new way to enhance aesthetic procedures? Aesthetic Plast Surg. 2013;37:973-974. 
  10. Wollina U. Perioral rejuvenation: restoration of attractiveness in aging females by minimally invasive procedures. Clin Interv Aging. 2013;8:1149-1155. 
  11. Broughton G, 2nd, Crosby MA, Coleman J, Rohrich RJ. Use of herbal supplements and vitamins in plastic surgery: a practical review. Plast Reconstr Surg. 2007;119:48e-66e. 
  12. Rowe DJ, Baker AC. Perioperative risks and bene ts of herbal supplements in aesthetic surgery. Aesthet Surg J. 2009;29:150-157. 


Michael Saco MD E-mail:................................................... [email protected]