About face

Evolving cosmetic procedures help keep Father Time at bay

Christi Adams of Melbourne Beach

Christi Adams of Melbourne Beach appreciates the refreshed look she gets from aesthetic procedures. HEALTH FIRST

Time marches on, often tromping faces in the process.

Fortunately for those eager to reconnect with their former youthful good looks, the garden of aesthetic procedures offers a harvest of techniques to erase those wrinkles and frown lines.

There are so many anti-aging options out there that it is almost an embarrassment of riches that leaves clients unsure of what would work best for their individual situation.

“Anti-aging technology is rapidly evolving and our clients are often confused about both technology and their specific needs,” said Dr. Emran Imami of Imami Skin & Cosmetic Center in Melbourne.

Add the fact that the industry is rife with aggressive marketing campaigns and the confusion only deepens.

“Patients are confused as to what they really need to achieve their desired look,” Imami said.

“Our role is to work with our clients to jointly determine what they truly need to achieve their goals.”

Using a combination of computer analysis, medical expertise and an artist’s eye, aesthetics specialists such as Imami can determine how best to help clients obtain the look they want. A little dab of detective work also helps.

“Oftentimes, clients can’t express what they don’t like about their looks, but it’s our job to hone in on how to achieve their goals,” Imami said.

The range of treatments is extensive and each option has a specific job. Most specialists will recommend a combination.

“There is a huge range of aesthetic procedures and treatments, and I know it’s hard to navigate for patients,” said Health First dermatologist Dr. Vanessa Johnson of Cocoa Beach.

Mary Lou Dryer and Dr. Emran Imari

Dr. Emran Imami, right, recommends a protein-rich platelet treatment for his client at Imami Skin & Cosmetic Center in Melbourne, Mary Lou Dryer. It is helpful for clients who cannot tolerate anesthesia. AMELIA HAMPSHIRE


Beyond plastic surgery, among the oldest and most trusted treatments is Botox, which improves the look of moderate to severe frown lines, crow’s-feet and forehead lines by relaxing the muscles.

“The longer it’s been around, the safer we know it is,” Johnson said.

Originally developed for neurology, Botox is a staple in aesthetics and used by more than 7 million people a year, according to the American Board of Cosmetic Surgery.

“As long as it is in the hands of a certified and well-trained injector, I think that this medicine is a very safe one,” Johnson said.

The more you use it, the better Botox performs.

“The first few treatments require more of the medication than subsequent treatments, because Botox over time helps to relax the muscles and over time it lasts longer,” Johnson explained. “I have some patients who instead of needing Botox every three months can go every six months. Some can even go a little longer.”

Research has noted that Botox can last up to a year, but only after repetitive treatments. It will last longer if you chill out and not grimace as much. Exercise, while great for the body, is not so good for Botox.

“Research has shown working out actually metabolizes the Botox faster, so it goes away quicker,” she said.

“Although I’m a proponent of exercise, I encourage patients not to exercise at least the first few days [after a Botox injection]. It’s important to reach a happy medium to where you’re not metabolizing your Botox really quickly, but you’re still maintaining a healthy lifestyle.’”

Johnson also noted that zinc supplements extend Botox’s effectiveness.


Botox eases lines, while injectable dermal fillers restore lost volume, smooth lines and soften creases.

The gel-like substances are embraced by more than a million men and women annually, according to the American Board of Cosmetic Surgery. Their popularity stems from the fact that they help one to look younger without much more expensive surgery and its downtime.

Fillers’ one failing was that they only lasted about a year. Not so these days.

“They’ve now gotten much better at designing fillers to where they last much longer and give more natural-looking results,” Johnson said

The latest filler technology is Vycross, which provides more lift and longevity.

Because there are so many options for fillers, a cosmetic surgeon’s guidance is critical in choosing which product works better in a particular area. Some fillers are better at plumping the marionette lines, while others work better to pout the lips and erase the vertical lip lines.

“Lip filler is one of the most popular treatments I do,” she said. “A little bit can make a great difference for patients.”


For a quick pick-me-up, dermaplaning can do the trick. The procedure uses a scalpel-like single blade to reach close to the skin for optimal exfoliation.

“Dermaplaning is removing a lot of the peach fuzz and dead skin cells from the top layer of skin,” Johnson said.

For folks facing a big celebration, from a wedding to a 50th high school reunion, dermaplaning can add a little edge to looks. With dermaplaning, the skin is fooled into thinking it has been injured, so the body boosts its collagen, which in turns serves to minimize lines and wrinkles.

“I usually reserve dermaplaning for that last week before the event,” Johnson said. “It’s going to give you that nice smooth skin.”

Dermaplaning also aids with the absorption of skin care products for that rejuvenated look with no downtime. Makeup goes on smoother, too.

Dermatologist Dr. Vanessa Johnson of Cocoa Beach

Dermatologist Dr. Vanessa Johnson of Cocoa Beach believes that Botox is very safe as long as it’s done by a certified and well-trained injector. HEALTH FIRST


Lasers and intense pulsed light encompass a variety of treatments.

“It’s a large subject,” Johnson said. “Each laser has a different target whether you are trying to get rid of pigment, wrinkles or blood vessels.”

Ablative lasers focus on the outer layer of skin, while non-ablative lasers pass safely through the outer layer, penetrating the underlying tissue. Both sweep over the area to be treated. Fractional lasers, on the other hand, penetrate the skin in micropinpoints.

Laser technology has advanced significantly in the past decade to accomplish the task with little time out for healing.


Instead of a dermaplaning blade, microdermabrasion depends on a minimally abrasive instrument to sand down the skin and remove the thicker outer layer. Like dermaplaning, it results in a refreshed appearance, but microdermabrasion has more oomph in reducing fine lines, wrinkles and enlarged pores.

Johnson favors the Diamond Glow, a new combination of microdermabrasion and medical-grade facial.

“It provides a great way for patients to get multiple skin care treatments all in one,” she said.


As a cosmetic procedure, microneedling, aka collagen induction therapy, has stood the test of time. The dermaroller used in the procedure contains tiny needles that pinprick the skin to encourage the creation of new collagen-rich tissue for a firmer skin.

“It does a great job, although you do need multiple treatments,” Johnson said.

“After 30, we stop making collagen, so this is a way to continue to encourage your body to make its own.”

A new modality that also encourages the growth of collagen is Ultherapy, which lasts longer than microneedling.

“Ultherapy give you deeper treatment using ultrasound technology,” she said “That collagen stimulation can last for some people up to five years, where microneedling you need to treat more often.”


Think of microcurrent, or facial toning, as a workout for the face. Microcurrent was first used in the 1800s to treat damaged tissue, until a physician noticed it also made faces look younger.

The technology emits extremely low-voltage electrical currents, mimicking the body’s own bioelectrical current, to repair damaged skin and stimulate the replenishment of collagen.

“It forces the body to repair itself,” said Corina Gata of Royal European Beauty Skin Care Studio in Cocoa Village.

Probes on pads placed on the face transmit mild electrical current that causes the muscles to contract and relax.

Corina Gata performs a microcurrent treatment on client Kim O'Grad

Corina Gata performs a microcurrent treatment on client Kim O’Grady as part of the Cocoa Beach salon’s facial tissue therapy. ROYAL EUROPEAN BEAUTY SKIN CARE STUDIO


Platelet-rich plasma uses the body’s own growth factors to stimulate new collagen and even new hair growth. This injectable treatment rejuvenates the skin by using the body’s own platelet-rich blood cells.

A small amount of the patient’s blood is harvested and placed in a centrifuge to separate the plasma from the blood. The plasma is then reinjected into the patient.

At Imami’s office, PRP is performed with an initial set of three injections spaced a month apart and maintenance treatment as needed.


Rhytidectomy, aka face-lift, remains the gold standard for anti-aging procedures. It can be performed in conjunction with a brow lift and eyelid surgery for additional rejuvenation.

Although more than 68,000 of these procedures are performed annually in the United States, it is not inexpensive. The American Society of Plastic Surgeons lists the average cost at $8,005, and that doesn’t include the anesthesia and other related expenses.

Cost aside, for some individuals, it is not an option.

Mary Lou Dryer, a patient of Imami, doesn’t handle anesthesia well and has been sick for days afterward. Dryer has opted for and obtained good results with PRP.

“I know I am doing something for me,” she said.

Regardless of modalities selected, a reality check is necessary for all aesthetic treatments. Christi Adams, one of Johnson’s patients, has the right idea.

“I started noticing aging and wanted to look refreshed, but not overdone,” said the Melbourne Beach resident, who has been using Botox and fillers for five years.

“I am not trying to look 30 or 40, but the best for my age,” Adams said. “I love it when people tell me I look so good.”

For more information

Imami Skin & Cosmetic Center
1140 Broadband Drive, Melbourne

Royal European Beauty
403 Brevard Ave., Suite 4, Cocoa Village

Vanessa Johnson, MD
105 S. Banana River Blvd., Cocoa Beach

Maria Sonnenberg
professor at Florida Institute of Technology | msonnenb32904@yahoo.com

Maria is a prolific writer and proofer for Space Coast Living and an adjunct professor at Florida Institute of Technology’s Nathan M. Bisk College of Business. When not writing, teaching or traveling, she can be found waging a one-woman war against her lawn and futilely attempting to maintain order among the chaos of a pack of extremely clueless wirehair dachshunds and an angst-driven basset hound.