Non-Invasive Anti-Aging Treatment Recommendations

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Dr. Sue Ellen Cox discusses anti-aging treatments from injectables to lasers and her process for new patient consultations

anti-aging treatment

A lot of people’s first anti-aging treatment is Botox. What should folks considering this treatment understand?
Botox, along with similar products Dysport, Jeuveau and Xeomin, belongs to a class of drugs called neuromodulators, which are typically used to reduce the appearance of lines and wrinkles. Results usually last three to four months. Neuromodulators are also used for TMJ, creating symmetry for Bell’s Palsy patients, shaping the jawline, reducing neck bands and correcting a gummy smile or downturned lips. Though all neuromodulators work the same way, there are subtle – but important – differences among the products. I conducted clinical trials for Botox, Dysport and Jeuveau, so I know the characteristics of each well. Expert knowledge of facial anatomy and experience with each of the products is the key to natural-looking results. For this reason, first-time patients should do their research when selecting a physician.

Dermal filler is another popular non-surgical treatment. Who is a good candidate for this, and how is it used?
As we age, many changes occur under the surface of our skin. Our skull changes shape, resulting in loss of support; fat pads shrink and fall; and collagen and elastin production slow to a halt. Dermal fillers can help reverse these effects of these anatomical changes. I can replace the support and volume that the aging process has diminished by strategically placing fillers. This is most observed by re-creating the cheekbones and jawline, reducing temple hollowing and masking the appearance of under-eye bags. An in-person evaluation best determines who is a good candidate for fillers.

In 2018, I began to use fillers in an exciting new way – as a biostimulate for collagen production on other areas of the body. After traveling across the U.S. and Europe teaching my technique, I learned even more along the way. This new method allows me to tighten skin on the body without adding any “volume.” Common treatment areas are the neck, chest, abdomen, buttocks and thighs.

anti-aging treatment

How does laser resurfacing play into your anti-aging regimen recommendations?
Lasers can help improve the tone and texture of the skin. As a baseline anti-aging treatment, I recommend one laser resurfacing treatment each year, supplemented with appropriate medical-grade skin care to maintain results. We have a laser for just about every concern, including brown spots, age spots, birthmarks, acne scars, surgical or traumatic scars, tattoo removal, uneven or dull skin tone, redness, pre-cancers, blue veins, red veins, wrinkle reduction, collagen stimulation, sun damage, rosacea and hair removal.

How does Aesthetic Solutions work with new patients to set them up for success?
I often meet patients who are suffering from information overload with so many non-surgical options out there. The most important thing for new patients is to have an initial consultation that focuses on concerns rather than treatments. You don’t need a chemical peel – you need options for treating sun damage and solutions to prevent it from coming back. During initial consultations, 2D and 3D facial imaging allows me to look under the surface of the skin for things like redness, pigmentation and volume loss.


Dr. Sue Ellen Cox is a board-certified dermatologic surgeon, and the founder and medical director of Aesthetic Solutions in Chapel Hill. Dr. Cox runs an active clinical research center and has performed clinical trials and pivotal studies on most neuromodulators and fillers on the market today. An author of more than 80 peer-reviewed articles and book chapters, she serves on committees and boards for the American Society for Dermatologic Surgery, the American Academy of Dermatology and various pharmaceutical and device manufacturers. Dr. Cox teaches cosmetic dermatology clinic to residents at the UNC School of Medicine and Duke University Medical Center when she isn’t lecturing internationally or directing national workshops.

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