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The Human Face

Understanding the basic make-up of the human face helps you understand the rhyme and reason for the various restorative and cosmetic techniques we use at Revive. Face musculature is complex, which explains in part why we are capable of so many different facial expressions and why our emotions can be so apparent to others. It takes a lot of effort to maintain a “poker face”, because our thoughts and feelings are so intimately linked to our faces. So, without further adieu, here is a simple mnemonic we used in medical school:


S is for skin, including the epidermis and the dermis. The epidermis is what’s treated during a deep facial cleaning. The dermis is where fillers are injected, and where the Neogen regenerates connective tissue to restore the face’s youth.

C is for connective tissue. This is a sheet of thin, tough, often whitish tissue that serves as a basement for the skin (both epidermis and dermis). Injected cosmetic fillers inevitably end up, in part, in this layer and deep to this layer, but that’s not harmful and in its own way adds to reducing the lines, wrinkles, sags, etc

A is for aponeurosis. This is simply a “coming together” of bundles of very tough, white fibrous tissue that gives muscles anchor points to pull upon, holds down muscles so that they push/pull instead of just bulge out, etc. Much thicker and tougher than the C connective tissue, the A aponeurosis really adds to the shape of the face and links up muscles. In fact, it is the layer that contains the muscles. Botox, the botulinum brand most people know, does its work in this layer.

L is for loose areolar tissue. This stuff is not unlike the C and A tissues, but is much thinner, less tough, more cushion-like. Sort of like the rubber mat beneath indoor-outdoor carpet that sits on the hard surface being carpeted. Not much gets done in this layer with our treatments.

P is for periosteum. This is the bone’s outer coating. It contains the blood vessels that dive into the bone to keep it alive, the repair cells needed to build and rebuild bone, etc. If you look at a raw beef or hambone straight from the butcher, periosteum can be scraped off with the edge of a knife. It’s not unlike the very smooth bark on certain trees. The periosteum is not part of regenerative cosmetic work, but is very important if you suffer facial fractures and need bones repaired.

Most of the work we do at Revive takes place in the epidermis, the dermis, and the muscles living in the aponeurosis.

So now you know!!!

Dr. Thomas Basch


Those of you familiar with my Revive practice know that we focus upon RESTORATION. As a physician, nothing is more fulfilling than unlocking the human body’s remarkable ability to repair itself. Platelet rich plasma therapy (PRP) may well be familiar to you already. Extracting platelets and harnessing their healing potential via injection into damaged tissue has become one of our mainstays. The Vampire (trademark) treatment system is based upon this remarkable capability. Many of you have already learned how potent this completely natural approach can be, and I predict that its applicability will continue to expand.

But platelet-rich plasma/PRP/Vampire (trade mark) treatments are just one of the restorative modalities we have nowadays. Hence, we are excited to be the first in West Michigan to introduce NEOGEN, an entirely new tissue repair and restoration approach. It is not a laser. It is not a surgery. It is not filler injection. It is a skin revitalization procedure that is changing the way we see facial aesthetic treatment. Interested? Read on.

Our skin has an inside layer (dermis) and an outside layer (epidermis). The inside layer determines the shape of our skin features. The outside layer determines our surface appearance and texture. Both are negatively affected by the aging process. Until very recently, aside from PRP, we just didn’t have much to offer in terms of actually rebuilding a healthy dermis and epidermis. We focused on making the best of the existing tissue. Neogen, like the PRP, is different technology. It has been designed to actually build new tissue in both dermis and epidermis, improving both shape and surface appearance of the skin.

Neogen applies energy, developed via radiofrequency, to ionize nitrogen molecule and transmit those ions to both the epidermis and dermis. This results in regeneration of the epidermis. Fine wrinkles are removed and skin texture smoothed, and discoloration reduces. But it is in the dermis, that deep structural layer of our skin that shapes the epidermis, where Neogen really stands out by producing new collagen (neocollagenesis) and well as new blood flow (neovascularization). Post treatment, as the weeks and months pass, these regenerative processes continue. The end result is the renewal of that youthful firmness we lose as we age.

With proper technique, Neogen is safe for most all skin types. The liberal application of topical anesthetic prior to treatment minimizes discomfort during the procedure. We can control the intensity of the treatment, so most patients will find the epidermis renewal well underway by days 5-7. By the second week post Neogen, typically makeup and sunscreen can be applied as per usual

We are excited to begin Neogen treatment at Revive this April. Stay tuned for our launch date, and plan to visit our office for your consultation and treatment.

Thomas M Basch MD

The “Secret” Behind Vitality As We Age

Dear Patients/Prospective Patients:

By the time we are in our middle years and beyond, we’ve really learned how to take better care of ourselves, and finally have discipline and consistency in our diet, our exercise, and our stress management. For many of us, the busy child rearing years have passed, and our careers are well established. In other words, we should finally be able to enjoy ourselves. But, we find that we really can’t. We lack energy. Our moods are subdued or downright low. We don’t feel a sense of vitality. Our libidos have mysteriously evaporated. We cannot sleep well. Our internal thermostats misbehave. Exercise has lost its payoff. Worst of all, there seems to be no logical explanation.

In many situations like this, the problem is hormonal, or more appropriately, a lack of the hormones required for a vibrant life. Hormones are the chemical switches and circuit breakers that turn on, turn off, and regulate the body’s organ systems. Without them, or with them in short supply, we simply do not function effectively and efficiently, and cannot tap into our physical and mental potentials.

Enter bioidentical hormone replacement therapy (BHRT). This treatment may well be the single most productive medical intervention for women and men who find themselves struggling, and yet it is shrouded by mystery, misunderstanding, and even ignorance. The human body produces over 50 different hormones, but it is the production of three of them, testosterone, estrogen, and thyroid, that suffers most as we age. Quite plainly, without these hormones in the correct ratio FOR YOU, you just cannot feel young.

As I look back upon my own professional career, I think of the countless patients I’ve seen and treated who could have greatly benefitted from BHRT, but I never considered it, and neither did most other doctors. We’ve long acknowledged the critical roles played by other hormones like insulin, vitamin D, and thyroid; we’ve known for a hundred years that we can’t live without these indispensable parts of our body chemistry. However, it has really only been within the past 20 years that doctors have acknowledged just how critical the GONADAL HOMONES, primarily estrogen and testosterone, are to our well-being.

Many of my Revive patients come to me upon recommendations from friends, colleagues, or family members. There is no better referral source than established patients who are doing so well that they have to share the “secret” behind their vitality. Feeling good again after years spent simply trying to get through the day is the sort of thing folks want others to experience. Many of my patients have been told that heir hormone levels are “normal” and no further treatment is needed. Two problems with this approach. One, the normal range as measured across the population is hugely variable, and two, normal for one person may well be abnormal for another.

Like most doctors, I never learned enough about hormone therapy in medical school to truly be comfortable with it. “First do no harm” is the golden rule among physicians, and the last thing I wanted to do was cause more problems for my patients . Yet as I read one well done study after another, I realized that in most cases, NOT trying BHRT is far more harmful than trying it. Knowledge truly is power, which is why I strongly encourage patients to investigate bioidentical hormone replacement therapy for themselves. I’ll list some of the studies that I feel my patients need to read. There is a good chance that their doctors are not aware of just how much we’ve learned about BHRT and how safe it really is. I too was a skeptic. It just seemed too good to be true. But my patients’ results have made me a believer.

At Revive, restoring youthful body chemistry via BHRT is just the beginning. I see BHRT as the critical piece that restores the POTENTIAL for vital, vibrant life. From there, it is up to each individual patient to make of it what he/she wants. Many patients simply want to feel energized again, or want libido restored to bring intimacy back into relationships. Others want to re-enter the competitive athletics they enjoyed in younger years, or perhaps just look and feel like they did back then. Whatever your goal, BHRT can help make all the difference.

If you are interested in learning more about how Revive Aesthetics and Wellness can enhance your life, please contact us for an evaluation.

Dr. Thomas Basch