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Self care without the guilt: look better, feel better

It’s a given. Watching your diet and exercising promotes good health, especially as you age. So how is beauty care so radically different? We work hard to take care of our insides as well as our bodies, but is paying attention to your looks such a narcissistic endeavor?

Med spa doctors and plastic surgeons get women and men of many ages through their doors. Some are trying to fix something that has bothered them, some are worried about how age is treating them, and others are just on a tear to look as gorgeous as they can be. And we enjoy addressing all of it. Some patients will not breathe a word about having come to us, as if spending money on themselves is the ultimate in self-centeredness. Many practitioners like me will admit that it’s rare their patients will even permit them to use before-and-after photos of them with their eyes blocked out and their identities hidden to show others how their treatments work. In other words, beauty care tends to be a deep, dark secret except, perhaps, between BFFs. 

While I understand this need to keep beauty care private, I also don’t see the need for shame. If you remodeled parts of your house or got your car repainted it would be no big deal. How are your looks any less something you own and keep up? In reality it just makes you feel better about yourself, so how on earth is this a bad thing? In her “(R)aging with Grace” article, Beauty Care: Feeling Good About Your Looks Past Age 60 writer Dena Kouremetis gets into the meat of it. “I often hear resignation from my age 60+ peers about keeping up with beauty care, but when I think about the alternative, it just sounds unacceptable in my world of one,” says Kouremetis. “So I began looking for the advantages to beauty care past age 60 and found that it’s not uncommon to be shamed by others about wearing makeup and/or appreciating it. She quotes a psychologist who argues that activities that allow us to take care of our personal beauty needs should not be viewed as “guilty pleasures.”

We have been carefully taught to suppress our interest in our looks, especially as we age, as if aging is a lost cause. In fact as many (women, in particular) age, they stop wearing makeup or doing skin care, accepting whatever nature hands them. And that’s fine. It’s a free country. But to put down others because they enjoy trying to look fresher and younger? That’s just not right. There are no absolutes where self-esteem is at stake. When you feel great about how you look, you have a better outlook on just about everything.

Morgan Shanahan’s Babble article I Got Botox and Didn’t Tell my Husband tells the story of a woman’s guilty pleasure. While she wanted to get rid of a wild eyebrow that had bothered her all her life, she failed to tell husband, Scott, that she was going to get Botoxed. “Three days later I woke up to discover I had no movement in my forehead whatsoever. It looked pretty good, but HO-LY was it a weird experience. My first reaction was to run in to Scott and make him poke my forehead and watch me try to raise my crazy eyebrow. But I couldn’t. Because I’d lied by omission and I was in it to win it now.” She goes on to say that about 6 months later she admitted it to him at a party.  “The thing is, my husband does think I’m beautiful no matter what. He also never noticed that I had frozen a quarter of my face. But now that he does know, our trust has been damaged. He can’t believe I would have gone and done something like that without telling him, and honestly … neither can I.”  While Shanahan loves what the injections did for her, the penchant to keep it a secret took a toll in this case.

While self-care is now a popular topic, many women find it necessary to justify spending money on beauty. One of my clients told me that each beauty product or procedure she spent money on began to feel like a small victory after years of feeling guilty about it.  She also told me that this was quickly followed by remorse and then another round of justification. When she discovered what she purchased actually worked, however, there was euphoria. This is a cycle that repeats itself, but there is no reason she should continue to suffer from it.  We have one time to go around, and there is no reason to think that an investment in your looks is not a prudent one.

Kouremetis said it best: “Having dominion over my looks means have a sense of control over something.  The concentration with which I apply eyeliner is unmatched and when I’m done with my going-out preparation I feel more confident to face the world.”

Anti-Aging Options Beyond Filler and Botox

“Nature gives you the face you have at 20.  It’s up to you to merit the face you have at 50.” 

Coco Chanel was ahead of her time when she uttered this, and never was it truer than today, when combinations of treatments and good skin care make youthful-looking skin last longer than ever. There is no better time in history to have birthdays than now, with anti-aging treatments capable of producing more extraordinary results than we ever thought possible. 

With all these anti-aging options available to you, where do you start?  Do you choose botox, filler, or skin treatments?  As a medical professional who has studied these treatments and their results in earnest, the answer is all of these choices.  While each category fills a different need, all work in harmony to minimize wrinkles, add volume in the cheeks and lips, and give you glowing skin.

Botox rules. It is the number one anti-aging aesthetic choice, providing a safe, reliable result when used properly. (We will explain “properly” in a moment.) No other product delivers such immediate results for wrinkle improvement than botox.  The optimal places for anti-wrinkle treatments with botox are crows’ feet (wrinkles around the eyes), “eleven” lines (wrinkles between the brows), and fine forehead lines.  While treatments for these areas are easily treated, forehead treatments can be a bit trickier. It’s important that your practitioner correctly balance both the anti-wrinkle result as well as the brow position or you may find your botox treatments causing unintended results.  Aggressive treatments with botox in the forehead can result in brow lowering, abnormal elevation of the brow, or uneven brows.  None of these results add to your anti-aging efforts and may even have the opposite effect — making you look “overdone.” Bottom line?  Botox in the forehead is best done conservatively.  Understanding the goals and limitations of botox is the first step in achieving an optimal result.   

Fillers came along as an alternative to botox, but are equally important — another product that can achieve that immediate anti-aging result.  Filler is a great option to add volume to the areas of the face that have decreased over time.  Using it in the cheeks and lip areas can create amazing results, creating the youthful look of a full face.  Nasolabial folds (upper mouth fold) and marionette lines (lower mouth wrinkles) can be filled as well, but should be considered only after the cheeks and lips have been appropriately evaluated.  Filling the nasolabial folds and marionette lines will raise folds and can create a somewhat unnatural upward smile (we’re sure the “Joker” Jack Nicholson look is not what you have in mind).  If budget is not a concern, I recommend filling all these areas, with cheeks and lips being addressed first.  Full cheeks and lips offer a youthful and sultry look. If you’re worried about lip injections, don’t. When performed properly (there is that word again) as an anti-aging technique, lip injections simply remove wrinkles and create natural looking fullness.

Somehow I think that if photofacials and lasers were available when Coco Chanel was in her 30s or 40s she would have looked even more amazing.  These are the anti-aging game changer.  Glowing skin with improvement in collagen and elastin has never been easier, safer, and taken less downtime.  The younger you start the treatments, the better your skin looks as you age, as if it resides in some form of  (happily) arrested development.  Photofacials and laser treatments promote the building of collagen and elastin which decrease wrinkles in the skin.  In addition, the devices I use promote a smoother skin texture and evens out pigmentation.  Our office uses the Sciton photofacial and laser device.  This brand is often referred to as the “luxury line” of laser machines.  Sciton’s motto of “because results matter” means what it says.  Not all devices are equal. Choose carefully and wisely to avoid a poor outcome or complication.  Scarring and burns can occur if a photofacial/laser is used poorly or aggressively. My advice is to choose Sciton or simply research the device you plan to have used on you before making a final decision.

Consider botox, filler, photofacials and lasers in combination to maximize your anti-aging regimen.  The goal is to use all these products in reasonable measure to achieve the kind of  outcome that will have you smiling and everyone else asking why you look so good!

~Dr. Andrea Tse

The photofacial: reinventing your skin

I know nobody likes the way skin responds to aging. Did you know that skin cells rejuvenate every 27 days during the youthful years? As we age, however, this rejuvenation naturally slows. It’s just part of life.

Eventually everyone experiences fine lines and decreased skin tone or even worse — heavy wrinkles — some by their 30s. How the skin ages is a combination of genetics, sun exposure, and sugar intake. In the past, the only modifying factors were sun exposure and diet.

The dangers of sun exposure and tanning are no secret any more, believed to be responsible for up to 90% of the visible changes attributed to aging. But did you know a diet high in sugar can slow down skin cell turnover? Sugar in the diet causes glycation. This is a scientific term for a process where high sugar intake leads to inhibition of DNA proteins and lipids. This leads to the slowing of the skin cell turnover process. The result? Dull, uneven skin tone.

The BIG news is that skin genetics can now be modified. In the past if your mother and/or father gave you the gift of inheriting heavy wrinkles at an early age, there was no solution other than an early face lift. Sciton’s Forever Young BBL treatment has revolutionized the way skin ages by changing skin genetics. This photofacial has been shown to modify DNA at the cellular level in several medical studies conducted at Stanford University. The studies concluded that BBL treatments promoted the gene expression of younger skin in older women treated with three sessions of BBL. When the DNA of middle aged women treated was sequenced, the DNA matched the sequencing and function of women 5-10 years younger. Finally — a modifiable option for skin genetics.

Maintaining your skin health with proper skin care to ensure skin health and vitality is essential to avoiding visible signs of aging. I personally have watched the rosacea and texture of my own skin improve with BBL treatments and I refuse to be sad about getting older. (Besides, everyone knows the only way to avoid getting older is to die young and I have no intention of doing that.) Instead I will out-smart aging by continuing to have gold standard anti-aging treatments on board.

For more information on BBL treatments and how effective it can be, call OptimalU at (916) 886-0220 or email us through this web site, optimaluclinic.com. I care about YOUR skin — not just how it looks now, but how it can look in the future as well!

~ Dr. Andrea Tse

An introduction: a new year, a new blog!

Starting this blog is an opportunity to inspire and inform about beauty, about aging well, and about my passion to make a difference in people’s lives. My goal is to provide education and insight gleaned through experience, research, and personal knowledge.  My hope, however, is that you will find the blog a source of information to age well and beautifully the same time. 

I became a doctor  with the goal of fighting disease. Over the past 14 years I have been an anesthesiologist, helping to care for people while a surgical cure to a disease they possessed was taking place.  During this time period it became clear that many patients lacked insight into understanding how individual choices were contributing to their disease, all contributing to their aging poorly.   After being involved in a few hospital wellness projects for patients, I began to develop a new understanding of just what the word “wellness” meant.  I realize now that wellness is made up of a number of elements that contribute to a person’s lifestyle, not the least of which is their appearance.  Some of my clients began requesting Botox, citing my gentle touch with needles during procedures. Initially I begrudgingly obliged.  To my surprise, however, the patients who received these beauty treatments seemed more motivated to be or stay healthy to match their improved appearance.  It was as if seeing a person in the mirror who began looking 5 to 10 years younger provided a higher level of commitment to stay healthy. 

Botox has evolved to become a surprisingly simple and safe way to appear younger. So after treating a few clients with it, I was asked about administering other aesthetic options as well.  Looking for med spas around the greater Sacramento area to refer these clients to for more services, I noticed that there weren’t any aesthetic clinics with a focus on anti-aging and wellness.  Many offered opportunities to grasp at youth, but the aesthetic websites did not emphasize basic well-aging techniques.

When I set up OptimalU, my goal was to be different and to reassure my clients and potential clients that they are in good hands. Instead of focusing on dollar volume, I wanted to offer treatments I knew would stand the test of time.  OptimalU employs a multi-modality approach — something I will explain more about in later posts here. Suffice it to say, I believe treatments and injections may not be the best way to go unless both the patient and I can clearly see a long term benefit to them.  Client photos are used clinically — kept on file to demonstrate the progress being made.  Reviewing these photos showing how an individual’s appearance has improved over time is one of my favorite parts of the entire process.

I hope to post often to this blog, but will consider talking about any topic of interest to you. Please don’t hesitate to ask!  I look forward to being your personal beauty/well-aging expert (they go hand in hand!). My biggest reward is the great feeling you have about yourself when you look in the mirror. And to all those who have already referred friends and family after their own experiences at OptimalU, a hearty thank you and Happy 2019!

~Dr. Andrea Tse


Dr. Andrea Tse is a board certified physician who focuses on the total person.

She offers the finest anti-aging laser treatments by Sciton, proven to provide anti-aging benefits at the skin's deepest levels. Dr. Tse also performs several non-surgical procedures to tighten, brighten, and make the skin look like it did years ago. Her specialized aesthetic training as well as her artistry combine to assure the most beautiful results.

Dr. Tse is also a passionate proponent of physician-grade supplementation to restore the body and, simply stated, make life better.

She provides her patients even more—a compassionate ear and a true partnership. Her patients know they are both cared for and cared about.