Understanding Facial Aging: Non-Linear Aging Process
Why is it that some people (other people!) seem to age slower? It's not fair! Plastic surgeon Dr. Bryce Cowan explains the complexities and factors that affect the timeline of aging, in the first part of the Science of Facial Aging series.
Treatment Options for Facial Aging
Can you reverse the aging process? Dr. Bryce Cowan gives us the truth about aging, cosmetic surgery, and the difference between non-invasive procedures like Botox/fillers vs cosmetic surgery.
Selecting from IL-23s
Tildrakizumab (Ilumya) is a brand-name biologic medication that’s used to treat moderate to severe plaque psoriasis. This drug is an interleukin (IL-23) inhibitor that’s very effective and works long-term to control the symptoms of psoriasis.
Tildrakizumab effectiveness
People with psoriasis are frequently frustrated over treatments that are ineffective for them, such as tumor necrosis factor biologics, phototherapy, or systemic drugs (such as methotrexate). IL-23 inhibitors, like tildrakizumab, can be an important and effective therapeutic option when patients do not respond to other treatments.
Introduction to Mohs Surgery
Mohs surgery is an advanced technique for removing skin cancers that combines histological analysis under a microscope at real-time with surgical excision.
The Cost of a Fat Grafting Procedure
What is the cost of fat grafting compared to injectable fillers? Plastic surgeon Dr. Bryce Cowan explains that it depends on the timeline, the patient’s age, and what they are looking for. Fat grafting is initially more expensive compared to fillers, but has greater longevity by a wide margin.
Fat Grafting: What is it?
What is fat grafting? Plastic surgeon Dr. Bryce Cowan explains this important rejuvenating options that is used both in restorative surgery (after a trauma) and for cosmetic purposes.
Surgical Excision and Histological Analysis in Mohs Surgery
In the third video of the Mohs Surgery series, plastic surgeon Dr. Bryce Cowan explains in further detail the combined process of surgical excision and real-time histological analysis of the excised tissue.
Recovery Time After Fat Grafting Procedure
Plastic surgeon Dr. Bryce Cowan explains what expectations patients should have in terms of recovery time. Can patients go right back to work the next day, or run a marathon?
What to Expect After a Fat Grafting Procedure
In this video Dr. Bryce Cowan explains what the patient should expect after a fat grafting treatment in terms of results, as well as the side-effects that patients can expect following the procedure.
Botox, Injectable Filler, and Cosmetic Surgery to Treat Aging Face
What cosmetic procedures might be useful for a given patient? The two key principles of aging of the face are volume loss and tissue malposition. There are many elements changing simultaneously, so it's very rare that there is an effective singular procedure that can act as a fix all solution.
The Recovery Process after Mohs Surgery
Reconstruction surgery is required after any Mohs Surgery procedure. Typically the wounds will take over a year to completely heal after the surgery. 10% per month is a typical rate of healing, with the peak at around 2 months.
How Long Do the Grafted Fats Last?
Typically grafted fats are long lasting. In this video Dr. Bryce Cowan explains how long fat grafts last in typical scenarios. The longevity of the grafted cells are one of the key selling points of this procedure.
Who Would be the Ideal Candidate for Cosmetic Surgery to treat Aging Face
The ideal candidate depends on the specific treatment, but in general terms, we are looking at a patient who is a healthy, non-smoker, does not have high blood pressure, does not require anti-coagulants, is in their late 40s or early 50s, where the impact of the surgery is highest.
Managing patients on Tildrakizumab
Tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor offers a convenient dosing schedule. Treatment is administered by subcutaneous injection at start of treatment, after 4 weeks, followed by every 12 weeks thereafter.
Improved Skin Quality with Fat Grafting
Grafted fat is transferred as whole cells which are believed to contain stem cells that release cytokines and growth factors. This promotes a rejuvenative process in the surrounding skin.
Alternatives to Mohs Surgery
In this video Dr. Cowan explains common scenarios where a doctor might not recommend Mohs Micrographic surgery, and might opt for another treatment modality instead.
Risks Associated with Fat Grafting
Plastic surgeon Dr. Bryce Cowan explains the risks associated with the fat grafting procedure that patients should be aware of before undergoing the procedure. Although serious complications are rare, it’s important to be aware of the various potential risks.
Preparing for Mohs Surgery
Patients need to take some important steps prior to surgery to maximize the outcome of their procedure. The first step for a patient is to ensure that their surgeon is a qualified Mohs surgeon...
Debunking Common Misconceptions about Aging Process
What cosmetic procedures might be useful for a given patient? The two key principles of aging of the face are volume loss and tissue malposition. There are many elements changing simultaneously, so it's very rare that there is an effective singular procedure that can act as a fix all solution.
Mohs surgery in Canada, Numbers and Facts
In Canada, there are only a very limited number of qualified Mohs surgeons at this stage, but that number is growing. The health care system in Canada is run at the provincial level, and currently there are only a limited number of facilities where Mohs surgeons can practice at.
Reconstruction Surgery After Mohs Surgery
A very common question from patients concerning Mohs Surgery is “Will I need reconstruction surgery?” Dr. Bryce Cowan explains why reconstruction surgery is necessary to optimize the final outcome, and outlines the process and importance of this with some examples.
Tildrakizumab effectiveness related to trial results
After 12 weeks of treatment with tildrakizumab (Ilumya), over 50 percent of patients can be cleared of their psoriasis. This biologic drug was approved in Canada in October 2021.
Tildrakizumab candidates
Unlike many other psoriasis treatments, tildrakizumab can be used in higher-risk populations, such as in the elderly or those with psoriasis in addition to other health conditions like inflammatory bowel disease (IBD) or psoriatic arthritis.
General thoughts on Tildrakizumab
With the availability of tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor, dermatologists are very optimistic about the continued success of this biologic drug used to treat psoriasis patients.
Advantages of Cosmetic Surgery when Treating Aging Face
What are the advantages of cosmetic surgery over soft procedures like Botox and dermal fillers? The main advantage is that cosmetic surgery allows for a more profound and long lasting correction that's not possible with other treatment options.
Face Aging: Decade by Decade
The upper, mid, and lower face all age as we go through the decades. Dr. Bryce Cowan explains how symptoms of aging typically manifest over time.
Skin Cancer and Genetics
Patients often ask whether they are likely to have skin cancer if their mother or father had this problem. Being a genetic combination of your parents, what you do inherent is the same skin types.
How Do I Choose a Surgeon?
Plastic surgery is a serious undertaking, and requires a lot of trust in the performing surgeon. In this video we asked plastic surgeon Dr. Bryce Cowan what patients should be looking for when choosing a plastic surgeon or a clinic.
Patient Research: How Would Patients Choose Their Surgeon?
Patients need to be able to both understand and accept the risks of surgery. It's a balance between their motivation and desire to undergo surgery and their willingness to accept the risks involved with that procedure.
Expectations vs True Risks of Surgery
What's the difference between true risks and expectations of surgery? Dr. Cowan explains the difference.
Ideal Fat Graft Candidate
In this video plastic surgeon Dr. Bryce Cowan explains the ideal candidate for a fat grafting procedure. Every procedure has its strengths and weaknesses, and it’s important that patients understand these factors as well as the cost and risks that they are willing to tolerate. An important video for those considering fat grafting.
Common Misconceptions about Anti-Aging Procedures
What are the most common misconceptions that patients often have about procedures. As a patient, it’s important to understand the various risks, costs, the likely outcomes, and what you want from the procedure well to gain the most benefit.
The Cost of Treating Aging Face
Patients need to be able to both understand and accept the risks of surgery. It's a balance between their motivation and desire to undergo surgery and their willingness to accept the risks involved with that procedure.
Mohs Surgery: The Gold Standard Treatment for BCC and SCC
Why is Mohs Surgery considered the world's gold standard treatment for BCC and SCCs? Dr. Bryce Cowan explains the types of cancers that are typically treated with Mohs surgery, and why the procedure has such as high cure rate.
Tildrakizumab long-term effectiveness
Research has shown high levels of effectiveness are maintained for 5 years and beyond with tildrakizumab (Ilumya), an interleukin-23 (IL-23) inhibitor.
Fat Grafting and Volume Loss of the Face
At what age do we start losing volume in the face, and in what areas? Plastic surgeon Dr. Bryce Cowan explains the process of volume loss with age, and how it affects the overall appearance of the face, and how fat grafting can help combat these changes.
The Controversy Surrounding Melanoma and Mohs Surgery
Patients often wonder why Mohs is not the standard treatment for invasive melanoma, the most dangerous of skin cancers. Dr. Cowan explains why the use of Mohs surgery is considered controversial for treating invasive melanomas.
Factors that Affect Cure Rate in Mohs Surgery
Mohs micrographic surgery is often used to treat recurrent skin cancers. In this video, we ask Dr. Bryce Cowan whether previous attempts to remove skin cancer can affect the prognosis of Mohs surgery.
IL-23s: Psoriasis therapy overview
Biologics are protein-based medications that target specific parts of the immune system. IL-23 inhibitor specifically targets a type of cytokine called IL-23 and blocks cellular activity, which results in reduced inflammation that causes psoriasis.