Archive | February, 2012

Master of Puppets

28 Feb

Ha. I made a Metallica reference! Not sure how many of my readers are Metallica fans… but still… go me for creativity points. ANYWAYS. This post is about puppet lines, also known as marionette lines. A client of mine inspired the title of the post.

“My granddaughter looked at me and said Nana you look like a puppet!”

Children are so painfully honest sometimes.  A patient of mine told me her granddaughter’s statement was her reason for being in my office.  (Maybe I should be employing two year olds?… Is that legal?  Can I pay in candy?)

Her granddaughter was referring to the folds that develop from the corner of the mouth to the jaw line, also known as the “marionette line,” one of the more advanced signs of aging.

Can you fix it?

Yes.  By injecting filler medial to the folds.  The product I typically use is Radiesse, because these folds are usually deep and require a thick volumizing fill. How I do things might not necessarily be how other providers do them… but it should be pretty similar. I also stand behind this product choice. If someone tries to use a Hyaluronic Acid in this area, get out of their office, because you will be spending a FORTUNE.

Before



What Needed To Be Done?

In Physical Facial Changes That Occur As We Age I spoke about what happens to the face as we age.  In this case, I’d like to point out prejowels beginning and marionette lines starting.

Marionette Lines

Prejowel lines

Topical numbing cream is applied to the areas that will be treated for about 20 minutes. The skin is then cleaned with alcohol. The full length of the Radiesse needle is inserted and product is deposited in a technique called fanning and product is deposited as the needle is withdrawn. The outside hub of the needle is a gauge larger than the inside to create a tract for the product to be placed. So the only discomfort is the actual needle, I add lidocaine to my Radiesse (which most people do). Really, not so bad as far as pain goes.


 The needle is inserted at the “X” and it goes straight up to the corner of the mouth. Like I said, product is inserted as the needle is withdrawn. This is called retrograde technique. Before the needle is taken out it is repositioned at a 30 degree angle, the full length of the needle is again inserted, and product is deposited as it is withdrawn. It is done again at a 45 degree angle.


Basically, it’s one insertion point (i.e. one poke) on each side, and the needle is pivoted while within the skin layers. It gets less painful as you go along because there is lidocaine mixed into the product.

Last the jaw line is sharpened. “X” is the insertion point. The full length of the needle is then inserted, and product deposited as it’s withdrawn.

After

This picture is immediately after. There is some swelling that has begun, but you can see some of the immediate results. This patient used a 1.5cc Radiesse syringe (the large). She could use a little more product in the jaw line and around the corners of the mouth. I personally like to do things one syringe at a time. Because swelling begins immediately, I find results are best this way. Also, some people don’t want to look perfect, they want to look IMPROVED. The most important thing to note on this client is that she no longer looks like she is frowning when her mouth is at rest. Fillers are AWESOME!

Side Note

Sorry friends, this is a super busy week for me! I have a 20 person Botox Party on Friday, on top of my regular clients! I will actually be seeing this patient again this week, and will have a non-swollen after picture for you. She looks amazing and is super happy! Yay!

*If YOU Are Considering Filler*

Fillers can bruise. Do NOT. I repeat. Do NOT do these things if you have an event within two weeks. This is a worse case scenario for bruising. Highly unlikely you will have a bruise for two weeks… but… I wouldn’t wanna chance it if I was planning on running into my ex-husband at my high school reunion and the whole reason I wanted to get filler was to look too good for words. Just saying.

The reality of the situation is you will bruise. Probably for a few days. You can cover it with make-up. And tell everyone you went to the dentist. (I know my friend Colleen-a dental hygienist- is going to yell at me for making the dentist sound bad. Sorry Col. I love the dentist. I really do. He makes for a great excuse for my clients.)

Expect to pay $300-$800 in the Boston Area for this treatment with Radiesse. The amount of money you spend is a direct correlation to the result you will receive. The amount of product you will require for the result you desire (poetry!) depends on a lot of different factors, so ask your provider!

ICE YOUR FACE AS MUCH AS POSSIBLE AFTER THIS TREATMENT. The more you ice, the less you will swell. Twenty minutes on, 20 minutes off. If you can do it the rest of the day, do it. If not, just ice as much as possible.

Observing Surgery: Blepharoplasty

24 Feb

Case Study:

Today I assisted in a blepharoplasty on both the upper and lower lids of a man in his late 50’s. Interesting right? This stuff is not just for women. And before you have any thoughts about it being a gay man you are completely mistaken. This man was a blue-collar, married man.

This patient’s wife, mother, and other relatives had undergone the same procedure. His upper lid was so saggy it impeded his vision tremendously. Genetics plays a large role in how we age, and considering this man had a number of family members who had undergone the procedure, saggy lids clearly ran in his family tree. The women in his family had such great results; the patient was ready to go under the knife. In 3 hours time, he looked about 20 years younger than when he walked in the door, but the most important part for this patient: his vision was improved! He couldn’t believe what a difference it made!


Time:

10:00 am : Patient is given oral sedation and pain medicine. The procedure is done under conscious sedation (patient is awake but comfortable).

11:30 am : Patient has reached adequate level of sedation. Patient is marked on the lids, where the surgeon will be cutting, and local anesthesia is injected into the area.

12:30 pm : The right eye is finished. Top and Bottom lids have been cut and stitched. The patient already states his vision is improved! AND he looks 20 years younger!

1:30 pm : The left eye is finished. Top and Bottom lids have been cut and stitched. The patient is shown his results. The eye is then taped at the sides to kept tension off the sutures.

Stats:

Total time of procedure start to finish: 3 ½ hours

Total time taken off patients face: 20 years

Total cost to patient: $5,250 (Upper only is $3,250 and Lower only is $3,250)

Follow up: The patient will return in 1 week to have the “tension tape” taken off and the non-dissolvable stitches removed (both dissolvable and non-dissolvable are used).

Downtime: About a week of being black and blue, and having the tape on your face. Tape is in though… Tape is the new black! (Just kidding).


(From the ASPS website)

Also known as a “Bleph.” The technical term for eyelid surgery. It improves the appearance of the upper eyelids, lower eyelids, or both by giving a rejuvenated appearance to the surrounding area of the eyes by removing skin and fat. The result gives a more rested and alert appearance.

Almost 200,000 Bleph procedures were performed in 2011, and it remains in the top 5 most popular cosmetic surgery procedures.


Treatable conditions:

  • Upper eyelid surgery can remove excess fatty deposits that appear as puffiness in the upper eyelids.
  • Loose or sagging skin that creates folds or disturbs the natural contour of the upper eyelid, sometimes impairing vision (like in the case study!), can be treated by eyelid lift surgery.
  • Lower eyelid blepharoplasty can remove excess skin and fine wrinkles of the lower eyelid.
  • Bags under the eyes can be corrected by blepharoplasty.
  • Lower eyelid surgery can correct droopiness of the lower eyelids, showing white below the iris (colored portion of the eye).

Is it right for me?

A blepharoplasty procedure is usually performed on adult men and women who have healthy facial tissue and muscles and have realistic goals for improvement of the upper and/or lower eyelids and surrounding area.

You should undergo blepharoplasty surgery for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Good candidates for cosmetic eyelid surgery are:

  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers
  • Individuals with a positive outlook and specific goals in mind for blepharoplasty
  • Individuals without serious eye conditions

You must tell your doctor if you have any of these medical conditions:

  • Eye disease such as glaucoma, dry eye or a detached retina
  • Thyroid disorders such as Graves’ disease and under or overactive thyroid
  • Cardiovascular disease, high blood pressure or other circulatory disorders or diabetes

Prevention

If sagging lids run in your family, there are things you can do to prevent going under the knife. Botox is used to lift the lid (but it can only lift so much). Ulthera is also being used as an alternative to surgery. But remember, non-invasive and minimally invasive treatments won’t give you the extent of the result surgery will. If you start doing this alternative procedures at a younger age (say mid 30’s) you are more likely to prevent the need for surgery.

Keratin. By Angel.

19 Feb

 

What is keratin and what’s the big deal?

Keratin is fibrous protein found in the outer layer of skin and in hair, nails, feathers, hooves… Ok, not really expecting the hooves and feather part… Anyways… Keratin Treatments are a commonly known, in-salon service for your hair. We’ve all seen the Pantene Pro-V commercials where it shows the hair shaft with damage from heat and chemicals. Salon treatments of Keratin restore these damaged areas. This strengthens the hair shaft, preventing breakage.


My Personal Experience

My personal experience with Keratin is with the brand- Coppola and I can’t say enough good things about it.

3 Reasons – Keratin by Coppola changed my life

 

  1. Have you ever seen a lion, that was me without Keratin enough said.
  2. Rainy days used to be sick days; I didn’t want to scare the general public with my crazy hair!
  3. Any type of water, summer activity was banned for me. See how Keratin can change your life!

Keratin by Coppola

There are two types of Keratin Treatments by Coppola. The Keratin Smoothing Treatment and Keratin Express Blowout are both great options for people with frizz, damage, and curly hair. This product will reduce the frizz, help repair the damage, and calm down some of your curl. These are not relaxers, and your hair is not going to be super straight post treatment. People with normal to thick hair might find the Keratin Smoothing Treatment a better fit for them as people with thin to fine hair find the Keratin Express Blowout a better option. Ask your stylist which one would be a better fit for your hair.

 The Keratin Smoothing Treatment

The Keratin Smoothing treatment is done in salon. Hair is washed with a special Keratin Shampoo. The hair is then blown dry and the Keratin Smoothing Treatment is applied, and left on for about 35ish minutes. Your hair is then blow-dried again (with the treatment still in), and flat ironed with a 450 degree flat iron. The treatment is left in your hair for 3 days. It is then washed with a special Keratin Shampoo and Conditioner.

The Keratin Express Blowout

The Keratin Express Blowout is also done in the salon. Hair is washed with a special Keratin Shampoo, and product is applied to the hair. The hair is then blown-dry and flat ironed. Eight hours after the treatment is applied, the hair is then washed, but I suggest waiting 24 hours and then you’re good to go.

Post Treatment

You MUST use a Keratin Shampoo and Conditioner! Now, you can use pretty much any sulfate-free shampoo…but why would you pay the money for the service and cheap out on the shampoo?!

Now that your Keratin service is done, your hair should feel silky, smooth, shiny and help repair damage. You’ll be able to blow-dry your hair in half the time – it’s amazing! It can rain outside and you won’t need to hide, you can go in water and not have your hair FREAK out and turn all lionesses on you while at the pool or beach. The product should slowly start to release itself from your hair the more you shampoo, so try to go every other day to get longer results.

Rumors, Rumors

Ok, I know the formaldehyde rumors. Formaldehyde is a chemical widely used in manufacturing and household products. Some Keratin treatments contain 0.2% or less of this chemical. I’ve been doing the keratin for a few years now I haven’t grown a tail, extra toe or horns. Coppola claims their product does not contain formaldehyde, which is one of the reasons I prefer this product.

URGENT!! BEFORE DOING THE TREATMENT FIND OUT THE BRAND!

Keratin is just a generic treatment term – it is not a brand. There are hundreds of Keratin brands out there, and it’s important to find out what your salon is using. Keratin treatments range from $25 to $400. If you are getting charged $300 for the service, make sure you are paying what the treatment is worth!

The hair industry is built off word of mouth. If you are in the market for a good Keratin treatment, get recommendations from your friends and co-workers. PLEASE do not buy a discount deal and expect glamorous results. Invest your hair. It is one of the most important features to a woman! In fact, it is widely considered the most important feature to our self-image!

 Please visit

Ulthera – Skin Tightening Ultrasound Therapy

15 Feb

Ugh. Gravity.

As an aesthetic nurse, I have found the most common complaints come from sun damage and gravity. Sun damage you can prevent (like… stay out of the tanning bed, wear sun block, and use retin-a!). But what about gravity?

I don’t think we’ll be living on the moon anytime soon (according to Ken Jennings, the guy who won Jeopardy for 6 months, the moon landing was a hoax, and I believe him… just sayin…). Therefore, we need to know our options.

I’ve done a few posts about fillers (Radiesse and Juvéderm) and I’ve talked a little about bio-enhancing agents (Sculptra). These are minimally invasive procedures that last about a year or two, have little downtime, and are great options for a lot of gravity stricken areas. But… of course, there are other options.

Ultra Sound Therapy

Ulthera. The newest in non-invasive procedures. This technique uses ultrasound (yes, like the kind of technology to see a baby) to deliver low levels of focused energy below the skin. As a response, collagen is stimulated, and a gradual tightening and firming occurs.

Visible effects include a lifting and toning of sagging skin. In FDA clinical trials, 9 out of 10 patients had a noticeable, significant lift of the brow line. See ya lata blepheroplasty (eyelid plastic surgery)! Patients reported firmer better-fitting skin in other areas of the face and neck as well. There is also an invisible result from the treatment with the creation of new collagen, which can help slow the rate of skin aging.

Treatment areas include the upper face, lower face, and neck. That’s right. No more turkey neck! It is pending FDA approval for that saggy arm skin and post-baby tummy skin. SEXY!

Feedback

Does it hurt?

Although I personally have not had an entire treatment done… I have been told it’s not the most pleasant feeling. As the energy is delivered closer to areas of bone (i.e. your forehead)… it gets a lil uncomfortable. You can receive a nerve block in some of the treatment areas (local anesthesia). It feels like burning I’m told. But, my patients claim they would do it again in a heartbeat.

Is it immediate?

There are immediate results, but the collagen stimulus continues for about 90 days.

Is it for you?

Do you have skin that has “relaxed” to the point of looking and feeling less firm? A lowered brow line or sagging skin on the eyelids? Turkey neck? Then it might be a good option for you. If you’re in your late 20’s (*cough* like me), then this might not be an appropriate treatment for you. But I think it’s a great option for older women, especially who hate their necks or who are not interested in Botox (even though Botox is AWESOME).

Before and Afters

These are from the brochure via my phone. Not the best pics… but… I kind of can’t use my actual client’s pictures. Due to HIPAA regulations. Hopefully Alexis from Image will send me her before and after pics soon so I can replace these!

**This picture is showing the skin tightening above the eye area. The pictures to the left side are before treatment and the pictures to the right side are 90 days post treatment. You can see the degree of hooding over the eye has changed drastically. These pictures are good representations of what to expect. They are just bad photography on my behalf! Sorry!!!

Alexis Before and After

Before

Immediately post treatment

24 hours later

Botanical Ingredients in Skin Care Products

13 Feb
Ingredient Known Benefit    
Aloe vera Soothing, regenerative, moisturizing
Arnica (Arnica montana) Regenerative, soothing, antiseptic, stimulating
Calendula (Calendula officinalis) Regenerative, soothing, antiseptic
Camphor (Cinnamomum camphora) Anti-inflammatory, antiseptic, astringent, cooling, sedative
Carrot (Daucus carota) Purifying, regenerative
Cucumber (Cucumis sativus) Moisture-binding, soothing, softening, tightening, anti-inflammatory
Geranium (Pelargonium sp.) Strengthening (capillaries), smoothes, decongests
Hops (Humulus lupulus) Calming, restorative, estrogenic, antiseptic, emollient, astringent
Horsetail (Equisetum arvense) Anti-inflammatory, regenerative, strengthening, softening
Lemon (Citrus limonum) Antiseptic, purifying, lymphatic stimulant
Menthol (Mentha piperita) Antiseptic, analgesic, calming, cooling, circulation stimulant
Peppermint (Mentha piperita) Antiseptic, cooling, analgesic, calming
Rosemary (Rosmarinus officinalis) Regenerative, astringent, calming
Sage (Salvia officinalis) Antispasmodic, astringent, antiseptic, cooling
Spearmint (Mentha viridis) Anti-septic, cooling, analgesic
Tea tree (Melaleuca alternifolia) Antiseptic, germicidal, wound-healing, anti-inflammatory
Turmeric (Curcuma longa) Stimulating, regenerative, antiseptic, antioxidant, anti-inflammatory
Witch hazel (Hamamelis virginiana) Anti-inflammatory, wound-healing
Yucca (Yucca schidigera) Anti-inflammatory, soothing

I know there are some people out there who love anything that is “natural” (and they live in Cambridge) and love things such as “botanicals” (I don’t know why I put that in quotes… but it seems grammatically correct?).

Botanicals in Skin Care

Botanical extracts support the health, texture, and integrity of the skin, hair, and nails and are the largest category of pharmaceutical/cosmeceutical additives. (I guess people in Cambridge aren’t the only one’s who love natural products!)

All medicine (including the creams for your skin) come from either nature or are manmade in a lab (in Cambridge?). Penicillin comes from a mold derivative; Botox comes from a bacteria derivative, ect. Ect.

Nature provides us with plants that have very important functions in healthcare. Here’s a chart with some of those plants. (In other news… I found out I can type something in Microsoft and upload it directly to my blog! I’m so excited! My posts are about to be more visually pleasing!!! Charts and graphs and clip art and stuff!)

The Q-Switch. A Post In Honor of N.

6 Feb

Making mistakes in life happens.  Luckily, most mistakes don’t result in permanent marks on our bodies.  But what about the ones that do?

Tattoo’s are becoming more and more mainstream.  In my opinion, I think they can be a beautiful artistic expression of who you are.

I have a few tattoos.  Yup, it’s true.  A heart on my back from when I was 18.  A Scarlet Begonia on my foot from my DeadHead days (also true), and “A Beautiful Little Fool” in Russian on my ribs (from The Great Gatsby).  Actually, I think this excerpt might be quite appropriate for this post.

“All right… I’m glad it’s a girl. And I hope she’ll be a fool–that’s the best thing a girl can be in this world, a beautiful little fool.”

My Friend N. – A Beautiful Little Fool

A dear and wonderful model friend of mine, N., has a tattoo that she doesn’t exactly love.  Frankie.  The name of an ex-flame on her thigh.  Fortunately for N., I have access to a q-switch.  (She’s gorgeous huh?)

What’s a Q-Switch?

It’s a laser that uses Alexandrite (the gemstone) to break up pigments in the skin.

Getting Rid of ‘Frankie’ – literally and metaphorically

First, I beg of you.  NEVER NEVER NEVER tattoo a name on your body.  Ever.  Unless it’s your dog or your kid…you willlll regrettttt it.  I promised my dad when I was 17 years 11 months and 30 days old that I would never put a name on myself, and it would never be in a place you couldn’t hide.  I’m all about branding… but in terms of marketing, not in terms of inked ownership.

Getting rid of a tattoo is not as easy and quick as the actual tattoo.  Oh no.  It’s painful, can take 8-20 treatments over several months depending on the colors and the age of your body art (pigment changes and becomes embedded in the skin over time, the older the tattoo the harder to treat) and there’s always a chance you will have a little ink left.

Red, yellow, and orange tones respond the best and quickest with the q-switch.  “Frankie” is done in black ink.

How much will tattoo removal cost?  Depends how big the tattoo is and how many sessions you will need.  But you’re not only looking at pain… but you’re looking at some money.  $300+ per session.

In conclusion:

THINK BEFORE YOU INK!

Pictures of the process will be posted as treatments go on!

Be Memorable. Brand Yourself. A Post on Individuality.

4 Feb

 Beauty Defined is physical attributes in conjunction with psychological traits.

There are certain characteristics that are considered “universally beautiful,” that are timeless and cross-cultural; however, the concept of “beauty” is so much more complex.  Individual ideas also defines the term, and therefore, beauty is a word that is considerably subjective and that makes it so much harder to define.

Individual Ideals

Opposable thumbs and the ability to reason (ok… maybe our ability to be unreasonable?) is what sets our species apart from other animals.  But what sets us apart from each other is our personality.  As women, I think we place a lot of importance on being treated as individuals.

Take a minute.  Write down how you would describe your beautiful personality. 

Physical Qualities

Defining your personality is usually easy for most people, and for some reason, a lot of women have trouble seeing their own physical beauty.  We can all agree “beauty comes from within” and from this statement we can conclude that anyone can be beautiful.

Always Be Yourself.

I know this might be hard for some of you because of my theory on Self-Worth Dysmorphic Disorder but now I want you to write down your favorite physical attribute.  What is the most beautiful thing about your appearance?

Universal traits are not unattainable.  They’re the easy part!

It’s important to highlight your best attributes.  I like to call it branding yourself.  🙂 

One of the first things my mentor (and lawyer) told me is you need to be more conservative.  You represent your business.  Well… I’ve at least started to dress conservative.  But changing my fun, crazy personality… that might take a while.  🙂  I work in the spa industry, where the dress code is black…. black… and more black.  My new thing is pink lipstick, it brings out my best physical attribute without drowning it: my eyes!  And it drowns out the black and uniformity that is what I wear everyday.  Even in a sweatshirt, pink lipstick makes me feel hot!  And in the end, it’s all how you feel about yourself.   

Your clothes don’t make you who you are, your face does!  Ok, fine… and your personality. 

Yep, sometimes I could use a brush

 Remember… There Has Never Been A Smiling Face That Was Not Beautiful!

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