Save Your Skin: Interview with famed plastic surgeon Dr. Lista

By: Mariana Bockarova
Let me begin this article by telling you that I do not have perfect skin.  My skin has been so flawed, in fact, that it has taken me many years to unveil my face in public without having to wonder whether friends or strangers alike would stare at my blotchy red sun-burnt skin, or bury my flaky cheeks into my shawl in particularly turbulent times. My struggle with skin care, however, is not unique, nor new.
I sat down with renowned Plastic Surgeon, Dr. Frank Lista, in hopes of exploring some of the most common skin problems, and just how they can be solved.
” The one message I have is that there is no one product that you should use. You should use a whole program, because good skin care involves more than just one thing. It starts with cleansing, then exfoliating, then active agent, then calming and protecting. Skin care is a lot like hiring a personal trainer; you wouldn’t dream of going to a personal training and doing only one exercise. Skin is exactly the same.”
My Experience: Throughout my teenage years, I was one of those girls. I italicize ‘those,’ because I now know what it is like to stare at women with perfect skin and ask myself ‘how?’  The truth, however, is that even ‘those’ girls do not have perfect skin. They have simply received good advice early on, rarely changed their routine, and invested in the best products for their skin type — concealer included. As a result, they’ve saved themselves the grief, money, and time it takes to deal with the ordeal that is acne – the struggles associated with which often feel like swimming in uncharted waters.
What is it?
“There are two types of acne: when your hormones are first kicking in, when you’re a teenager.  Most people grow out of that. There’s the second type, adult-onset acne, which is hormonally mediated acne. What happens is that hormones stimulate sebum production in the glands at the base of your hair follicles and your skin, and if the keratin blocks those hair follicles, the sebum can’t get out. That inflammation, the red spots, come from a blocked duct. ”
What to do about it?
If you think your acne might be related to your hormones, make sure to see your doctor. Recent research suggests that a low glycemic index diet, where you eat less refined sugars, carbohydrates, and sugar-containing foods, acts to balance insulin and lessen breakouts. Eliminating milk from your diet can help too. In the meantime, products containing retinoids, benzoyl peroxide, and salicylic acid are your best bet for clearer skin.
Sunburnt skin and brown spots
My Experience: I am legitimately allergic to most sunscreen products that are sold on the market today. However, that fact hasn’t stopped me from spending hours and hours in the sun, silently hoping that the dermatologist-issued warnings are wrong, and praying my sun-bathed skin does not catch up to me. I used to think that a burn was a pre-curser to a wonderful, glowing tan. The freckles that have now begun to emerge, however, tell me otherwise.
What is it?
“The reason you get brown spots usually is because of exposure to sun. It causes an increase in melanin production and that becomes permanent. If the melanin (the brown pigment in skin) is not stimulated uniformly, we get localized increase of brown spots. What we don’t like is a variegated completion, we’d like it all to be uniform in color. ”
Something else worth mentioning – the degree of damage might also be culturally specific: As Dr. Lista, an Italian-Canadian, notes, “”Italians share a lot of the same skin problems that most Mediterraneans do. Because we are of Mediterranean of origin, we don’t burn as easily as people from Nordic countries. Because we don’t burn as easily, we think we can sit out in the sun for way longer than people of more northern climates, but the damage that occurs to the skin is equal…we get more sun, we get more damage.”
What to do about it?
Depending on your skin tone, a prescription bleaching cream could work wonders. While it’s more costly, chemical peels can also improve the appearance of brown spots. As the epidermal layer of skin is removed by the acid in the peel, new skin grows to match the surrounding color.
My Experience: As I fall into the 18-24 year old demographic, my experience with wrinkles is, thankfully, limited. My main concern, currently? Prevention. My mother’s? Regression.
What is it?
“There are two reasons. If the muscles in the skin are overactive and fold a certain way, eventually that line is going to become permanent, like a crease in a pair of pants. The reason it happens as you get older, is because as we get older your skin loses its elasticity, it’s ability to bounce back. It also thins. So you’ve got thin, inelastic skin which is folding over and over and over again.”
What to do about it?
Preventative measures, like wearing sunscreen, sleeping well (on your back!), and getting enough sleep are always helpful whether experiencing your first or tenth wrinkle. The U.S. Food and Drug Administration does not regulate or test anti-wrinkle moisturizers, and classifies them, instead, as cosmetics, which makes over-the-counter products hard to trust. The only FDA-approved treatment for wrinkles, topically, is tretinoin, otherwise known as Retin A. Other procedures known to lessen wrinkles include laser resurfacing, where a laser removes the top layer of skin to produce more collagen, and wrinkle-fillers such as botox and collagen.
Dry Skin
My Experience: Raised in Canada, the harsh winters have not been friendly to my skin. I am often left with a face so dry that it begins to flake, or, worse, crack when I smile, leaving me in a particularly painful state.
What is it?
“Dry skin is the opposite of acne-prone, greasy skin. You have dry, delicate skin. It’s very thin, they don’t have very much oil production. Oil lubricates the skin, so they don’t have very much protection. Those patients have very sensitive skin, so we need to be very gentle with the skin.”
What to do about it?
Look for products that seal moisture, such as those containing petrolatum or lanolin, and remember to moisturize frequently throughout the day.
Eyes: Puffiness and Dark Circles
My Experience: Exam day, for me, is most often accompanied by rings around my eyes and puffiness that make others wonder if I’d been crying. Though it does go away after a restful night’s sleep, I know that eventually, that might not always be the case.
What is it?
“There are a lot of reasons why you could get puffiness. Lots of times, it’s retention of fluid; if you drink too much one night and withhold a lot of water, the fat cells underneath your eyeball will bulge out. The other main reason is the fat cells which your eye sits on are held in place in a rigid scaffold of muscles. As you get older, that gets loose and it can’t hold the fat anymore, so it bulges out.”
What to do about it?
Dr. Lista’s own line, Miracle 10 Skincare, offers a “light, hydrating antioxidant and botanically rich” eye treatment, which “refines, calms and moisturizes delicate tissue without irritating, even the most sensitive eye area,” which, among its benefits, acts to plump and firm eye tissue. He notes, “when we devised the eye cream, we were trying to restore firmness to those structures so that it doesn’t puff out.”

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