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Aesthetics

As a certified cosmetic injector for 8 years, I take great pride in making my patients look as good as they feel. It is important to me that each person I see is completely thrilled with his or her results. With real, noticeable results, no surgery and no recovery time, there are many reasons why BOTOX® Cosmetic has been chosen by millions of men and women.

What Is BOTOX® Cosmetic?

BOTOX® Cosmetic, introduced in 2002, as the first botulinum toxin to be approved by the FDA to temporarily treat moderate to severe glabellar lines between the brows. BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate-to-severe frown lines between the brows, crow’s feet, worry lines and laugh lines. BOTOX® Cosmetic is administered as a simple, nonsurgical treatment that is injected directly into the muscles between the brows and around the eyes. It works by blocking nerve impulses to the injected muscles. This reduces muscle activity that causes moderate to severe lines.

Before Treatment

To better understand your overall health, we will evaluate your medical history prior to treatment. A complete consultation will be performed in order to determine what areas are troubling you and what your outcome expectations are. A detailed treatment plan will be created for you and all questions you may have will be thoroughly addressed

The Botox Procedure

BOTOX® injections are performed without anesthesia because it is virtually painless. Only a very small sting is felt when the injections are made.

When will I see results from a BOTOX® Cosmetic treatment?

Within days, you may see a marked improvement in the moderate-to-severe frown lines between your brows. Lines continue to improve for up to 30 days, and results can last for up to 3-4 months. Individual results may vary.

Will I still be able to make facial expressions?

When administered by an experienced practitioner, you can smile, frown and look surprised without the wrinkling. Although the results are visible, a treatment with BOTOX® Cosmetic will not radically change your facial appearance or make you look as if you’ve “had work done.” My goal is to enhance the appearance of my patient’s in a natural looking way.

Post-Treatment Information

You can return to normal activity immediately following your BOTOX® injection. Slight swelling may occur but should cease within a few hours. For 4 hours following injection, you need to keep your head and neck upright. No strenuous exercise for 24 hours. Rarely, you may notice some slight bruising for a couple of days and it will gradually disappear. You may cover the area with makeup.

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Collagen Induction Therapy (CIT)

Collagen induction therapy (CIT) performed using the Rejuvapen utilizes 9 precisely spaced micronized needles to create invisible, vertical, micro perforations into the epidermis and the top layer of the dermis. As a result, the skin shifts its natural repair mechanism into high gear and begins producing collagen and elastin to repair these micro-perforations. The self-repairing property of the skin is a 100 percent natural form of skin renewal from the inside out. The advantage of the Rejuvapen is that it not only activate cell regeneration, but it also enhances the active ingredients of RP Complex into the skin during the treatment before the skin closes.

What to Expect:

CIT with Rejuvapen treats fine lines and wrinkles, acne scarring, surgical scarring, burns, stretch marks, and firms and tightens most body areas. Your skin becomes firmer and regains its elasticity, fine lines and wrinkles are visibly reduced, pores become finer, circulation stimulated and the overall condition of the skin improves.

Am I a Candidate?

CIT is suitable for all skin types, and ideal candidates are those who wish to improve skin laxity, smooth lines and wrinkles, slow the onset of the aging process or improve the appearance of scarring. Before Treatment – Before you undergo any cosmetic treatment, it is important to have a consultation with a qualified practitioner to ensure you are suitable for treatment. This will be your opportunity to ask any questions you have about the procedure and for the practitioner to explain the pros and cons.

Dermal Fillers

Cosmetic surgery isn’t for everyone, and today’s woman has a vast array of alternatives to combat the signs of stress and aging. A wide array of nonsurgical treatments are now available to improve your appearance, soften lines and wrinkles, and plump up facial contours. In some cases, these treatments are considered alternatives to going under the knife or as adjuncts to cosmetic surgery that can enhance and maintain the results. New technologies are increasingly less invasive and produce visible results without some of the downtime and discomfort of more invasive treatments over the past decade.

Injectible dermal fillers are among the most popular of these nonsurgical treatments. With the growing popularity of nonsurgical and minimally invasive cosmetic treatments, however, we have seen an increase in unqualified practitioners attempting to take advantage of the growing number of consumers seeking these procedures. You should know that like any medical procedure, dermal filler injections should be administered by a qualified medical provider who understands the neuromuscular and anatomical structure of the face as well as potential side effects of every product used.

Common forms of resorbable fillers are:

◦Hyaluronic Acid Gels (FDA-Approved Hyaluronic Acid Gel Filler Brands as of July 2010)

Juvederm Ultra® /Juvederm Ultra Plus® (Allergan)

Voluma XC®

Hyaluronic acid is a natural polysaccharide that is commonly found in the connective tissues of the body. Its normal function in the body is to bind water and to lubricate moving parts, such as joints. The most common areas for treatment are the nasolabial folds (creases from the nose to mouth), the nasomental creases (corners of the mouth), and the lips, as well as cheek and chin contours. Aside from expected temporary redness, possible bruising, or puffiness for the first day or two, there are few complications, if any.

Duration: 6-12 months or more.

Recovery: Recovery time will depend on the extent of the treatment and the amount of material injected. You may experience some swelling and redness for the first 24-48 hours. When large amounts of any substance are injected into the face, swelling may last from several days to one week. Most injectable fillers have short recovery periods, and you can return to work the same day or the next day. Some people swell more than others, and bruising is common but can be covered with concealer. In more extensive procedures, such as fat injections into multiple areas, local anesthesia or light sedation may be required.

◦Non-resorbable Fillers

These contain synthetic components that are not broken down by the body. They are considered permanent, because the particles cannot be removed, or “semi permanent,” because the particles are suspended in a substance that gets absorbed in three to six months. The term “permanent” can be somewhat misleading. As the aging process continues, you will need additional treatments.

Common forms of non-resorbable fillers are:

Bellafill® (Suneva Medical)

Bellafill (formerly known as Artefill) is a semi-permanent filler. It is made up of 75 percent bovine collagen and 25 percent polymethyl-methacrylate microspheres (PMMA), which are carbon-based polymers. PMMA has been used in dental work, hip prostheses, and bone cement. The product is mixed with a local anesthetic to numb the area to be injected. Over three months the collagen fibers get absorbed, leaving the PMMA, which is too large to be broken down and remains permanently. It is tunneled under the skin, massaged, and molded to fill the area to be treated. Bellafill can be used for acne scars, nasolabial folds, and skin depressions. Possible complications include lumping, inflammation, granulomas or localized hardening, rash, and the migration of the microspheres into other areas.

Duration: Collagen resorbs in 3 months, but PMMA particles are permanent.

Risks and side effect: The duration of dermal fillers is variable and depends on the formulation of the material, how deeply it is injected, how much product is used, as well as how severe the wrinkles or folds are. Most dermal fillers are only effective temporarily, so repeat treatments will be needed periodically

All dermal filler treatments are performed or supervised by a Board Certified Nurse Practitioner specially trained in Dermal Filler therapies. It may be recommended that you return in two to three weeks after treatment for a touch-up in case any refinements are needed.

Dermal fillers can be used to treat everything from superficial wrinkles to recessive cheek bones, restoring lost volume and reducing the appearance of lines around the cheeks, nose and mouth. Dermal filler procedures are administered in-office, take minimal time to inject, and can allow you to return to your normal routine almost immediately.

 

Collagen Induction Therapy (CIT)

Collagen induction therapy (CIT) performed using the Rejuvapen utilizes 9 precisely spaced micronized needles to create invisible, vertical, micro perforations into the epidermis and the top layer of the dermis.

As a result, the skin shifts it’s natural repair mechanism into high gear and begins producing collagen and elastin to repair these micro-perforations. The self-repairing property of the skin is a 100 percent natural form of skin renewal from the inside out. The advantage of the Rejuvapen is that it not only activate cell regeneration, but it also enhances the absorpition of active ingredients of RP Complex into the skin during the treatment before the skin closes.

What to Expect:

CIT with Rejuvapen treats fine lines and wrinkles, acne scarring, surgical scarring, burns, stretch marks, and firms and tightens most body areas. Your skin becomes firmer and regains its elasticity, fine lines and wrinkles are visibly reduced, pores become finer, circulation stimulated and the overall condition of the skin improves.

Am I a Candidate?

CIT is suitable for all skin types, and ideal candidates are those who wish to improve skin laxity, smooth lines and wrinkles, slow the onset of the aging process or improve the appearance of scarring. Before Treatment – Before you undergo any cosmetic treatment, it is important to have a consultation with a qualified practitioner to ensure you are suitable for treatment. This will be your opportunity to ask any questions you have about the procedure and for the practitioner to explain the pros and cons.

During Treatment – Before a medical skin needling treatment, a topical anaesthetic is applied to minimize any discomfort. Then the rejuvapen will be rolled over the skin to create evenly spaced puncture wounds. The length of the needles will vary depending on how deep into the skin the needles need to penetrate – generally, the deeper the penetration, the more dramatic results you will see. Treatment can take anywhere between 10-60 minutes depending on the area you are having treated.

Recovery – After Collagen Induction Therapy treatment, your skin will usually be slightly pink and you may experience some mild bleeding depending on the length of the needle used during your treatment. The downtime with this treatment is very quick and you should have recovered between 24-72 hours. A series of 3-5 treatments is usually recommended to achieve maximum results and as the results rely on kick-starting your body’s own collagen production, it can take 4-8 weeks before you start to fully see the benefits. It is also often advised to use cosmeceutical grade skincare at home to enhance your results.

Benefits – This minimally invasive skin rejuvenation treatment is designed to stimulate the body’s natural collagen production to improve the appearance of fine lines and wrinkles as well as scars on the face and body.

Risks and Complications – Risks associated with medical skin needling are minimal but can include dry skin or slight discoloration post-treatment. Any side effects of Collagen Induction Therapy should subside within a week or so.

Choosing a Cosmetic Clinic – Medical Skin Needling with medical grade rollers should only be carried out by properly trained medical practitioners, so it is essential to find a practitioner with experience and training in the treatment.

Platelet Rich Plasma Therapy (PRP) for Skin

What is Platelet Rich Plasma (PRP) Therapy?

PRP therapy is a newer form of regenerative medicine that utilizess your own blood, where the platelet rich plasma component is extracted, concentrated and reintroduced to rejuvenate the skin.

Platelets are the key to the body’s ability to stop bleeding and repair damaged blood vessels and cells in the body. Platelets contain substances called growth factors that activate and rejuvenate cells in the body. The concentrated platelets in PRP contain tremendous amounts of bioactive proteins, which include the growth factors. These growth factors have been shown to initiate accelerated tissue repair, and according to experts have also been shown to have positive effects on skin rejuvenation. The growth factors, when released,promote tissue repair, angiogenesis (capillary formation), and collagen production.

This treatment is associated with no risk of allergy or infections as we are essentially using your own byproduct.

Advantages of Using PRP

Advantages of using PRP include the following: tissue regeneration and rejuvenation, induction of cell differentiation, extracellular matrix formation, recruitment of other cells to the site of injury, and an increase in collagen production, which can increase skin thickness and overall skin health. In addition, PRP is non-allergenic, is an autologous physiological product, eliminates donor transmissible infections, and is a biological glue for tissue adhesion, especially in skin flaps, bone grafts, and trauma.

Preparation of PRP

To prepare PRP, a small amount of blood is drawn from the patient’s arm. The blood is then placed in a centrifuge that spins at high speed and separates the platelets from the rest of the blood components. The platelets collected in PRP are activated by the addition of thrombin and/or calcium glucarate, which induces the release of these factors from alpha granules.

The concentrated PRP is then injected into and around the affected area, jump-starting and significantly strengthening the body’s natural healing signals. Injections of PRP continue to heal the area over time, during 1 to 3 months. Because the patient’s own blood is used, there is no risk of a transmissible infection and a low risk of allergic reaction.

Clinical Applications and Procedure

Aging of the skin, dermal components, and cells means that the skin texture and appearance deteriorate and have been damaged. Aging affects the hands and soft tissue of the face, neck, and décolleté. This is characterized by sagging jowls, thinning of the skin, puffiness, age spots, and wrinkling.

In cosmetic medicine, PRP has been used to treat acne, scarring, and alopecia. It is also effective for skin rejuvenation and tightening around the eyes treating the thin crepe-like appearing skin and fine lines and in the following areas: cheeks and midface, thinning skin on the neck, jawline and submalar regions, back of hands, décolleté, and others (eg, knees, elbows, and upper arms, as well as for post-pregnancy skin laxity).

PRP is injected by multiple tiny punctures under the skin with the use or without topical local anesthesia. The process is painless if sufficient topical anesthesia is applied. When PRP is injected into the damaged area, it stimulates the tissue, causing mild inflammation that triggers the healing cascade. As a result, new collagen begins to develop. As this collagen matures, it begins to shrink and tightens and strengthens the skin, as well as the tendons and ligaments of the damaged area when it is injected at that level. Improvement in skin texture and tone is noticeable within 3 weeks. Full collagen regeneration requires 3 months. Topical skin care and light therapies can enhance these results. Advanced wrinkling cannot be reversed, and severe scarring may not respond to treatment. In my experience, surgical scars respond well cosmetically.

The PRP treatments can be used on all skin types and tones. Minimal swelling, bruising, and redness for the initial 12 to 24 hours are expected. A bruise at the needle stick site may be visible for 2 to 3 days. Swelling from the fluid is what the patient will notice first. During several weeks, the platelets stimulate months in most patients. Biannual touch-up treatments will maintain the results.

Considerations Before PRP Treatment

Certain factors (eg, smoking and alcohol intake) diminish stem cell release. Avoiding these will increase the success of the PRP procedure. The platelets work by causing an inflammatory reaction. If this inflammatory reaction is diminished, the clinical outcome is significantly compromised. For this reason, the use of anti-inflammatory drugs is not recommended. This restriction should be in place for about 1 to 2 weeks.

Exclusion Criteria for PRP Treatment

Although PRP is a promising therapy for most patients, the practitioner must take into account some considerations during the initial assessment before suggesting this treatment. Contraindications include the following: sepsis, cancer, chemotherapy, platelet dysfunction syndrome, critical thrombocytopenia, hypofibrinogenemia, hemodynamic instability, anticoagulation therapy, acute and chronic infections, chronic pathological conditions of the liver, severe metabolic and systemic disorders, and skin disease (systemic lupus erythematosus, porphyria, and allergies), as well as heavy nicotine, drug, and alcohol consumption.

Adverse Effects of PRP Treatment

Adverse effects of PRP treatment may occur, some of which are significant. The most common adverse effects are infection, skin discoloration and bruising, and pain in the injected area.

What Can I Expect After Treatment?

Redness, swelling, slight pain, bruising or all these signs can happen in the treatment area. These side effects usually subside in a few hours to a few days. Post care instructions will need to be followed through.