SCN: We know the sun does some serious damage to our faces, but does it really contribute that much to aging the chest area?

Doctor: Although the harmful effects of sun exposure are usually seen two or more decades later, 80 percent of the lifetime damage to the skin by ultraviolet radiation is believed to occur before the age of 18. This includes the development of roughened, coarse, leathery, wrinkled skin, a patchwork of pigment loss and unsightly brown spots and an overall diminution in tone and elasticity owing to depletion and disruption of both the elastic and collagen fibers in the dermis that give the skin its resilience and structural support.

It also frequently leads to a superimposed proliferation of an intricate, mat-like network of tiny, dilated, reddish, purplish, or bluish blood vessels (telangiectasia), often referred to (incorrectly) as “broken” blood vessels.

In no place are these changes more evident that in the broad, flat expanse of the dècolletè, the triangularly-shaped area of the chest extending down from the base of the neck to the cleavage between the breasts. Here, the accumulated damage I talked about earlier bears the tongue-twister medical name of Poikiloderma of Civatte, which is usually evident by the time a woman has reached her late 40’s or 50’s. To compound this picture, the unrelenting downward pull of gravity during periods of pregnancy, nursing and being overweight causes the breasts to sag with the passage of time.

SCN: Botox treats various fine lines and wrinkles; how does it help to create a younger-looking dècolletè?

Doctor: As it does elsewhere, Botox Cosmetic has proven effective for diminishing wrinkles, crinkles and crepe-like appearance on the chest. A few tiny microdroplets spaced along a straight line just above the tops of the breasts can help to reduce the appearance of vertical wrinkles.

To diminish wrinkles that run horizontally, all it takes is a number of minute amounts of Botox placed along an outwardly directed diagonal line beginning immediately above the inner side of each breast.

SCN: Can Botox help in other ways?

Doctor: Botox can be helpful for sagging breasts. Several different techniques have been developed. The one I favor consists of injecting small amounts of Botox into three sites along the chest muscles (pectoralis minor) located directly under the collarbone on both sides of the rib cage near the armpits. The slight weakening of these muscle areas that results allows three things to happen: 1) the shoulders are pulled backward by certain muscles in the back; 2) the posture is improved; and 3) the breasts are elevated.

SCN: What other non-surgical options do women have for the chest area?

Doctor: A series of mild chemical peels may be used to combat widespread tone and texture problems. These include Jessner’s solution (a mixture of low-potency acids), mild-strength trichloroacetic acid (10 percent to 25 percent) and full-strength glycolic acid (70 percent).

All have proven useful for smoothing the skin, lightening dark discolorations and refreshing the general tone. Four to six in-office treatments spaced at two to four week intervals are usually needed for best results. I have found salicylic acid (30 percent) to be the most effective agent for managing the dècolletè area, but of course you and your doctor must decide what’s best for you.

SCN: What can we expect, as far as downtime and fees go?

Doctor: While some people experience slight redness and mild scaling that may last for a few days, as a rule, there’s little or no downtime involved following any of these treatments. Fees for each treatment session may range from $250-$350.

SCN: It sounds like the above procedures are for mild issues; what works when a woman requires something more dramatic?

Doctor: When more severe skin damage is present we perform a Golden Peel Plus, which is a medium-depth peel. Breast lifts of up to two-thirds of an inch have been achieved in this way. Two treatments are sometimes needed to maximize the effect, and the benefits may last up to four months. Ideal candidates are trim and fit women between the ages of 30 to 50 who are slightly stooped and round-shouldered. Fees range from $450-$900.

?SCN: Does the Golden Peel Plus have other uses?

Doctor: A Golden Peel Plus can also be employed for non-surgical breastlifting, either alone or in combination with Botox. It consists of two steps. The first involves the use of Jessner’s solution (a mixture of several, relatively weak acids), which acts as a kind of “primer” coat. The second is the application of a Golden Peel (Resorcinol 53 percent) to the entire exterior of the breasts, including the nipple and areola (the red area surrounding the nipple). Both chemicals are left in place for several minutes before neutralizing. Although some women do experience slight burning and discomfort, no local or even topical local anesthesia is typically necessary.

SCN: What’s the downtime like? How many treatments are required?

Doctor: While a Golden Peel Plus can be performed during a lunch break, and may be considered a “lunchtime beauty fix,” the results aren’t immediate, and there is a short healing period.

Immediately afterward, the skin might be a bit red and slightly swollen. Three days later, the treated areas discolor to a reddish or light brown, and about two days thereafter, they form thick, dry, dark brown scales that take several additional days to fall off.

A series of four Golden Peel Plus treatments at two week intervals can raise the breasts by as much as two-thirds of an inch, which is a particularly gratifying improvement in cases of mild breast flaccidity. Fees per treatment range between $300 and $400.

?SCN: Laser treatments are very popular these days. Can they help with chest enhancement?

Doctor: Although lasers and intense pulsed light (IPL) have each been employed successfully for treating “broken blood vessels,” I prefer the use of radiowaves and have enjoyed great success with this modality over the years.

With this method, a small amount of radiowave energy, akin to the type that’s used by a regular AM/FM radio, is delivered through a hand-held probe and focused on the tiny capillaries. The disruption of the tiny capillaries leads to their ultimate disappearance. We can treat hundreds of blood vessels in this fashion in one sitting in a matter of minutes. Most people require only topical anesthesia to reduce the “sting” that might be felt as the radiowave penetrates the skin.

SCN: How effective is this method, and what's the cost?

Doctor: Approximately 75 percent of people can expect to see an average of about 75 percent overall cosmetic improvement following two to four treatment sessions scheduled at intervals of two to four weeks. Fees can vary anywhere between $300-$400 per session.

SCN: Any other procedures?

Doctor: If you’re looking to go bra-less, there’s nipple enhancement. Flat or inverted nipples, or nipples stretched by breast-feeding, are quickly restored using either of the two available hyaluronic acid filling agents, Juvederm or Restylane.

Following local anesthesia, a small amount of the material is instilled directly under the nipples to give them what has been referred to as a “perk up.” Results may last anywhere from six to 12 months, and a treatment generally runs between $750 and $1,000.

Got a question for Dr. Novick? Send him an email at info@skincare-news.com. Your question might be featured in an upcoming article.

Skincare-News.com thanks Dr. Novick for speaking with us about non-surgical chest enhancement and breastlifting. Check out the other interviews in our seven-part series on non-surgical rejuvenation procedures.

The Non-Surgical Rejuvenation Series:

Non-Surgical Rejuvenation: Dr. Novick on Non-Surgical Facelifts (Part 1)

Non-Surgical Rejuvenation: Dr. Novick on Non-Surgical Nose Jobs (Part 2)

Non-Surgical Rejuvenation: Dr. Novick on Non-Surgical Eye and Brow Lifts (Part 3)

Non-Surgical Rejuvenation: Dr. Novick on Non-Surgical Lip Enhancement (Part 4)

Talking Non-Surgical Neck Lifts (Part 5)

Chatting About Non-Surgical Hand Rejuvenation (Part 7)

____________________________

In addition to Dr. Novick’s role as bestselling author, clinical professor of dermatology at The Mount Sinai School of Medicine in New York City and attending physician, he is also a fellow of the American Academy of Cosmetic Surgery (FAACS) and maintains a private practice in Cosmetic Dermatology and Cosmetic Dermasurgery on Manhattan’s Upper East Side. He has been featured on many popular television and radio shows and lends his expertise to scores of major publications.