BOTOX® Cosmetic Procedures

Are you concerned about deepening frown lines between the eyes? Have you noticed wrinkles appearing on the forehead, between or at the corners of the eyes? Then the non- invasive BOTOX® Cosmetic procedure may be just right for you. BOTOX® Cosmetic is the most widely known, FDA approved and accepted treatment to diminish these problems. This procedure is performed for people  with very natural results.

The cosmetic form of botulinum toxin, often referred to by its product name BOTOX® Cosmetic, is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases and crows feet near the eyes. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance.

Patients may seek BOTOX® Cosmetic treatment for some of the following reasons:

  • To relax wrinkles of the forehead, and “crows feet” at the outer eye
  • To give the face a more relaxed and youthful appearance
  • To relax frown lines and wrinkles between the eyes
  • BOTOX® Cosmetic is a quickly performed and easily renewed procedure

BOTOX® Cosmetic works by weakening the muscles of facial expression. Once the resting tone of the treated muscles is weakened, the pull of the muscles relaxes and the overlying skin flattens. This approach is different from other non-surgical procedures for the face. Other non-surgical procedures work by filling wrinkles or depressions. By physiologically weakening the muscles, wrinkles are lessened naturally.

CO2 FRACTIONAL LASER

The CO2  Carbon Dioxide (C02) Fractional Laser Resurfacing removes layers of skin tissue in a fractionated method (columns of skin are removed, leaving the skin surrounding each column intact to aid in healing) to help reduce “age-spots” (also called sun freckles, liver spots, and lentigines), fine lines, wrinkles, scarring, uneven coloration, skin laxity, textural irregularities, dull tone, and a thinned collagen layer of the face, neck, and chest.

CO2 is the best treatment if you wish to get the most results with one treatment.  If you have the ability to take some time to heal (7-14 days), having this one treatment is like having multiple other non-invasive treatments at once.  It is also the best single treatment for advanced skin damage and wrinkling.

CO2 is an in-office procedure that requires pre and post-treatment medications to ensure proper healing and comfort during the procedure. Discomfort varies on the depth of the treatment. For your comfort during the treatment, we may apply a topical anesthetic or inject local anesthetic and/or tumescent anesthetic and prescribe sedative medications to reduce discomfort. After the treatment most patients describe the post-procedure feeling as a bad sunburn for about 12 hours to 2 days. Please also follow the instructions for all other prescribed pain medication is needed post treatment. We also recommend pain or relaxation medications prior to treatment therefore you will need to have somebody drive you home after treatment.

Typically  one laser treatment with C02 is recommended. Occasionally, in an area that cannot be treated aggressively, we may need to do more than one treatment to optimize results.   Maintenance treatments may also be necessary to maintain results, especially if sun is not avoided or proper skin care used. Occasionally, even with the best care, another treatment may be necessary in a few years (in the area around the eyes, it may only be 1-2 years).

How do I know if I need CO2?

Anyone who has sun damaged, aging skin, irregularly pigmented skin, wrinkles, sagging, irregular texture of the skin or other skin condition that could be expected to be improved with this treatment that understands the risks, costs and time necessary to achieve the full benefit of the procedure and who has realistic expectations of the ultimate outcome.

This is not a good treatment for skin of color.  The reason is that this is an aggressive treatment that does result in prolonged healing of the surface.  Pigmented skin tends to heal with hyperpigmentation and that does occur with this procedure upwards of 30% of the time. It can take many months of topical treatments and sometimes additional laser treatments to correct this.  If this treatment is to be undertaken on dark skin, it will need to be part of a series of gentler treatments and not a single treatment.

This is also not a treatment for any woman who is pregnant or anyone who has been treated with isotretinoin (or Accutane) within 6 months.  In addition, if there are any conditions resulting in delayed or abnormal healing or a history of cold sores or herpes virus it is important to tell your physician at the pre-treatment stage to prevent complications.

How does CO2 work?

The C02 Carbon Dioxide (C02) Fractional Laser Resurfacing removes layers of skin tissue in a fractionated method (columns of skin are removed, leaving the skin surrounding each column intact to aid in healing) to help reduce “age-spots” (also called sun freckles, liver spots, and lentigines), fine lines, wrinkles, scarring, uneven coloration, skin laxity, textural irregularities, dull tone, and a thinned collagen layer of the face, neck, and chest.

What benefits can I expect?

Results that are expected are a very significant and noticeable reduction in the components of sun damaged skin such as “age-spots” (also called sun freckles, liver spots, and lentigines), fine lines, wrinkles, scarring, uneven coloration, skin laxity, textural irregularities, dull tone, and a thinned collagen layer. The skin will continue to improve for a period of 6 months following the procedure provided proper skincare is used and sun exposure is minimized. Sometimes the results are not significant until the 6th and even the 9th month, depending on the person’s age, their aftercare routine and their history of smoking

What are the risks and side effects?

The main negative of the CO2 is the downtime.  Depending on the area and the aggressiveness of the treatment, it will take7-14 days for the skin to heal.  This downtime will include significant redness crusting (possibly minor bleeding and oozing depending on treatment depth), dryness, and peeling and flaking (it is important to keep the skin moist after treatment). This does mean that social and work activities will have to be curtailed during this time, although you should be perfectly capable of working from home after the first day or two.  It could be a very painful procedure but at Advanced Dermatology we provide full facial anesthesia so there should be no or minimal pain during the procedure or even in the hours following it.  Other potential side effects may include but are not limited to: skin wound, infection and scarring, hypo and hyper-pigmentation.

Prior to treatment all potential risks and side effects will be discussed with you by your medical provider and cosmetic coordinator.

How will I look and feel after the treatment?

After the treatment, you will go home and sleep mostly for the first day.  After the first day your skin will be raw and you will follow the instructions as to how to keep it healing maximally.  We usually see you in the office on the first, second or third day after the procedure to ensure that healing is going according to plan. By the 7th day you can usually apply makeup or venture out in public, but your skin will still be pink and will be very sensitive for the better part of 1-3 months.  It is most important to follow the instructions given to you by your provider. A strict skincare regimen and sun avoidance is recommended for best healing and optimal results for a period of 6 months following treatment. Failure to do so may result in sub-optimal results or side effects such as listed above.

Your skin will continue to age as time goes on due to sun exposure, environmental stress, overall health and lifestyle choices such as smoking. To maintain your results we recommend a healthy skincare routine including cosmeceutical products, medical grade facials, and other procedures as directed by your provider.

Juvéderm® Injectable Gel or  fillers

Juvéderm® Injectable Gel is a gel implant that includes hyaluronic acid, a natural complex sugar that bolsters skin elasticity, providing a smooth and supple appearance.

Juvéderm® Injectable gel under the skin to instantly restore your skin’s volume. Juvéderm® Injectable will smooth away facial wrinkles and folds, like your “smile lines” or “parentheses” (the creases that run from the bottom of your nose to the corners of your mouth).

Patients choose Juvéderm® Injectable Gel treatment for some of the following reasons:

  • To diminish lines and wrinkles around the eyes, nose and mouth
  • To provide a smoother look and feel to facial skin
  • To restore fullness to the lips
  • Ease of treatment with no “down time”
  • For a more youthful, relaxed and vibrant appearance

Juvéderm® Injectable Gel provides a smooth, natural look and feel that can last from six to nine months and is particularly effective for lip enhancement. Juvéderm® Injectable Gel can help you look younger and more relaxed instantly and without surgery.

Gel treatments usually take about 15 minutes with virtually no recuperation time. Most patients do not request anesthesia, although a local anesthetic is available if preferred.

Laser Treatments

Laser Hair Removal

Laser hair removal is an increasingly popular non-surgical cosmetic procedure. It is a non-invasive, convenient method to reduce hair growth.

Laser Hair Removal Technique

Depending on the area being treated, the process may take anywhere from several minutes to several hours to complete. The most commonly used lasers utilize a low energy laser beam. This beam passes through the patient’s skin and is attracted to the pigment of the hair. The energy passes down the hair shaft and is absorbed by hair follicles that are in the active growth phase, thereby disabling the hair follicle in the deeper layer of the skin. The hair follicles that are in dormant phase are not affected by the treatment. In most cases, minimal pain should be experienced and no anesthesia is required.

Laser Hair Removal Benefits

  • A non-invasive, gentle technique that reduces undesirable hair from most parts of the body
  • Treats larger areas effectively because it disables more than one hair at a time
  • May make skin color and complexion more uniform
  • Minimal discomfort
  • Replaces waxing, electrolysis, shaving and bleaching
  • No downtime

Laser Hair Removal Considerations

  • Laser hair removal is an ongoing process that requires multiple sessions because it only affects actively growing hair, and not all hair follicles are active at the same time. In addition, high energy levels are avoided so as to minimize the risk of injury to the adjacent skin
  • Occasionally patients may experience slight redness of the skin or mild swelling around the hairs
  • Sunscreen is recommended for any area treated that may be exposed to the sun
  • Patients with darker skin may not respond well due to inadequate discrepancy between skin and hair colors
  • Blonde or gray/white hair is less responsive due to lack of ample pigment in the hair

Pigmentation

Pigmentation-sometimes referred to as “permanent make-up”- is a technique in which minute, metabolically inert pigment granules are implanted below the epidermis for cosmetic and/or corrective enhancement. This ancient Asian beautification practice has gained popularity around the world. Pigmentation is used to enhance facial features like eyebrows, lashes and lips; to improve conditions like scarring and vitiligo (uneven pigmentation); or to reconstruct the nipple/areola breast area.

Technique

Typically, two treatments are needed and the standard is four to six weeks apart but is contingent upon the health profile and age of the client and the procedure conducted.. Needles penetrate the skin a few millimeters, in what is basically a tattooing process.

Benefits

  • No downtime and resumption of most normal activities within 24 hours for majority of patients.
  • Many pigment formulators use color additives that are on the FDA’s approved Food, Drug, and Cosmetic listings (as do SPCP supplier members,) however, the FDA does not approve the final product – the pigment used for tattooing – at this time.
  • The process is relatively quick. The process typically takes one and one half to two hours, although not all that time is afforded to tattooing; there are administrative and pre-procedure prep tasks associated with the service.
  • Skin returns to normal by the next day. Swelling or redness is generally mild.
  • Mild discomfort during procedure is avoided using topical and/or local anesthesia.
  • Good alternative for women with make-up allergies (although procedure is designed to enhance features, not replace make-up altogether).
  • Pigments are individually mixed for customized results, and designed to look natural. Results can be seen immediately (although full end result will be seen in about three weeks).

Other Considerations

  • Permanent procedure. Laser surgery is required to remove pigment.
  • Patients must avoid direct sunlight, refrain from applying make-up, and wearing contact lenses for a few days, and avoid swimming for several weeks.
  • A small number of patients may experience allergic reaction or infection.
  • Scarring is possible due to practitioner error. ASAPS recommends this procedure be performed under medical supervision.
  • Pigments may cause interference with cranial MRI scans.
  • Needles inserted too deeply in the skin can cause bleeding, spreading of pigments, and damage to hair follicles.


Microdermabrasion

Using unique fine crystal technology we remove the outermost layer of dry, dead skin cells by gently and precisely exfoliating the surface of your skin. For the best results we recommend a series of treatments that span over several weekly visits. The results are fresher, younger looking skin.clinique aesthetica Microdermabrasion uses medical grade crystals to remove the dead, outermost layer of skin. This skin exfoliation process reveals the new, living skin cells that are soft, smooth, and receptive to nutrients.

Microdermabrasion is used to treat and/or diminish:

  • Blackheads and whiteheads
  • Fine lines and wrinkles
  • Sun damaged skin
  • Acne prone skin
  • Superficial age spots
  • Hyperpigmentation
  • Oily skin
  • Dry or patchy skin

SkinMedica Vitalize Peel

The Vitalize Peel is a unique break-through formulation of mild acids that provide a complete, consistent and safe peel with no “downtime” and predictable results for all skin types. This non-invasive peel creates a softer, smoother younger looking complexion.

Used in combination with Microdermabrasion or alone, these unique plant and sugar acids break down the chemical bond of the intercellular glue that holds the dead skin cell layer together. Removing the top layer of skin (where most visible wrinkles are) allows the healthier skin cells to come through, giving a smoother texture to your skin and a glowing and radiant appearance. Your skin will look and feel more vibrant as sun damage is reduced and premature aging is addressed.
Micro Peel

In a unique three-step process your skin becomes refined and firmer, sun-damaged skin cells are cast off, oil and congested pores are unblocked.

We remove a micro-thin top layer of skin, which frees the skin of dead cellular build-up. This is followed by the application of an AHA appropriate for your special skin sensitivity and condition. This loosens the bond of dead cells within the pore. Finally, Cryogenic Therapy produces an anti-bacterial, anti-inflammatory effect on the skin. Pores appear smaller and the skin is left toned and refreshed. The procedure is concluded with the application of an appropriate moisturizer and UV protection.

Deep Pore Cleansing Facial Treatment

Enjoy the relaxation and therapeutic properties of a full facial treatment, which includes: cleansing, exfoliating, extraction when needed and a mask selected specifically to meet your special skin requirements, followed with an appropriate moisturizer and UV protection.

Ultrasonic Skin Rejuvenation

Ultrasound E-Stim addresses such conditions as hyperpigmentation, dehydration and poor elasticity. While using a combination of ultrasound and electrical therapy to micro-massage and stimulate the blood supply, we infuse your skin with healing topically applied ingredients. These are driven deep into the tissue resulting in healthier and more beautiful skin.

Ultrasonic Acne Control Treatment

Whether you are in your teens or thirties and forties acne can be devastating to your self-esteem. In order to restore clear smooth skin quickly, and provide lasting results, we use a combination of treatments. Cleansing and manual exfoliation are combined with ultrasonic-electrical stimulation in applying and antioxidant gel, which aggressively attacks skin discoloration from acne scarring. Your skin will benefit from increased blood flow, oxygen and healing nutrients.