Aesthetic Medicine: Tell us a bit about your background and how you came into the aesthetics industry.
Dr Alexis Granite: I am a US-trained boardcertified dermatologist who has been in practice for 15 years. I moved over to the UK with my family a decade ago. I am currently in residence at Skinesis Medical at Sarah Chapman and my practice encompasses both medical and aesthetic dermatology.
I love the combination of both, caring for the skin and treating a variety of skin concerns such as acne, rosacea, eczema and skin cancer, while also offering a full range of aesthetic treatments in my practice, from injectables to lasers and Ultherapy and everything in between. It’s a real 360-degree approach to the skin and to ageing overall.
AM: What is important to you when choosing treatments for your practice?
AG: There are a number of considerations when choosing treatments to bring into my practice. Safety and efficacy are two of the major factors: does this treatment do what is intended and have an established safety profile? Other things to consider – what is the downtime like, will this be something my patients will be able to fit into their busy schedules? If there is downtime or discomfort, is it worth the end result? Is this treatment an effective alternative to others already available but that may not suitable for everyone? Does this treatment fill a gap in the market? As the aesthetics industry is ever evolving, it’s important to keep in mind that just because a technology is new doesn’t necessarily mean it’s better. That said, the innovation in our field is pretty incredible!
AM: How long have you been working with Ultherapy and what do you like about it?
AG: I have been working with Ultherapy for the last seven years. I like that Ultherapy is non-invasive and has minimal downtime. So many of my patients are looking for non-surgical treatment options to boost collagen, and improve skin laxity and sagging, especially along their lower face, jawline and neck. For the right candidate, Ultherapy is an effective and long-lasting tightening treatment. It also complements many other aesthetic therapies, such as injectables and lasers, as part of a holistic rejuvenation treatment programme.
AM: What indications is it good for?
AG: Ultherapy is an FDA-cleared device. It is indicated for lifting of the brow, tightening and lifting skin on the face and neck, as well as improving lines and wrinkles on the décolletage.
AM: Why are collagen and elastin so important?
AG: They are two of the essential proteins that make up the bio-scaffolding of our skin. Both are produced by fibroblasts, with type I collagen representing 80-90% of skin collagen. Fibroblasts become less active from early adulthood and collagen production begins to diminish by 1-1.5% a year.
External factors such as smoking and UV and pollution exposure can also accelerate this decline. A number of the visible signs of ageing we see clinically are related to this loss of collagen and elastin, so boosting production of these proteins is fundamental to many rejuvenation treatments.
“So many of my patients are looking for non-surgical treatment options to boost collagen, and improve skin laxity and sagging”
AM: Have you used the Ultherapy device for ultrasound scanning before injectables?
AG: I don’t routinely use ultrasound scanning prior to injectable treatments, but for specific cases I do use the device to scan prior to injection. This can be particularly useful when treating over prior filler.
AM: What do your patients like about it?
AG: Patients tell me they like the need for only one treatment, lack of downtime and the results.
AM: Is the treatment painful?
AG: There is some discomfort with Ultherapy, so we do everything we can to minimise that. As practitioners, it’s really not enjoyable doing procedures that make patients uncomfortable!
We ask patients to take paracetamol and ibuprofen prior to their treatment and also apply numbing cream prior to the procedure. I will often break up the full face and neck into two treatment sessions as well. All of these measures help make Ultherapy much more manageable.
AM: Can patients really get results in just one treatment?
AG: Yes, that’s what makes Ultherapy such a great option. Although it is a bit of delayed gratification as it takes three to six months to see the final results from Ultherapy, just one treatment per area is needed.
AM: Do you use Ultherapy in combination with other treatments, and if so are there any combinations you find give particularly good results?
AG: Ultherapy can be combined with a range of different treatments to help amplify results and to also give the skin a little boost while patients are waiting for results to “kick in.” I especially like combining Ultherapy with skin boosters such as Belotero Revive and Profhilo as well as with PRP (platelet rich plasma).
Aquagold mesotherapy can also be done following Ultherapy to help improve skin texture and radiance. Always best to perform Ultherapy first to target the deeper layers of the skin followed by injectable and/or more superficial treatments.