Archive | May, 2012

More on Retinoic Acid (my fav!)

22 May

I LOVE RETINOL.  Every Woman Should Own A Retinol Product.  (Although the strength shouldn’t be the same for every woman!)

It is not just for acne; this cream has revolutionized nonsurgical treatments for sun-damaged skin (wrinkles!). Research shows it improves signs of both photoaging and photodamage.

Physical Change Results
Thins and compacts the top layer of the epidermis Smoother, softer skin texture
Thickens the lower layers of the epidermis Tightens the skin
Reverses keratinocyte atypia (some big acne word) Improves acne
Disperses melanin throughout epidermis (color of skin) Improves discoloration
Increases glycosaminoglycan deposition (sugars used for skin health) Increases dermal volume and tightens the skin
Increases neovasularization in dermis (blood flow) Gives a pinker, rosy hue to the skin

(Funny Story: My BFF Alexis recently read an article “Has facebook made you a narcissist?” … I told her “No, I’ve always been this way”… but really, your face is ALWAYS available to the public now.  Even if you’re not famous, you ARE!  Make sure you always looks picture perfect!  Nice skin makes life SO much easier AND more low maintenance.)

I’ve always recommended patients start on using a retinol product once a week and working their way up, but I’ve been reading that it should actually be done daily, starting at a low dose and working your way up. Retinol comes in several different formulations, the lowest being .01%. It can take two weeks for the skin to become acclimated to this product, and a little bit of redness or peeling can be expected.

If you are younger, and have less photodamage, or if you are older with sensitive skin a conservative approach to retinol therapy will give a good result (which will have little to no peeling or redness). Aggressive therapy is the only approach for thick, tough skin with severe sun damage. Peel baby peel (but don’t worry, the peeling will only be for two weeks or so, until your skin gets used to it… or physiologically… until your skin gets rid of all that dead stuff on top that’s making it look dull and yucky.)

If you are seeing an aesthetician and doing aggressive treatments like Microdermabrasion. or in-office chemical peels (‘Tis the Season for Chemical Peels! –but the summer is NOT) you should not use retinols until you are done with your treatments. AND hopefully after your treatments are finished you can use a more conservative retinol product to keep your skin looking good after treatments.

Retinol comes in 3 forms:

  1. Cream (.025%, 0.05%, 0.1%)
  2. Gel (0.01%, 0.025%)
  3. Liquid (0.05%)

But guess what. The carrier of the product can intensify the results. Creams are more moisturizing. Gels contain alcohol, and this makes it penetrate deeper. Alcohol also has a drying affect, which can irritate the skin even further. The liquid also is drying due to the effects of alcohol content.

(Yes. I really own this much retinol)

How to Use:

More is not better! Start with a pea size amount for your entire face.

(Retinol products are always yellow-ish in color).

My Skin:

I personally use a night cream that has Retinol and Glycolic. Once a week or so I add a Retinol booster (liquid retinol) to my moisturizer which sometimes makes my skin peel a little because it boosts the effect of the retinol by allowing it to penetrate. I recommend retinal products for everyone. Remember, this product makes you photosensitive; i.e. you should not be in the sun when you use it! …But you shouldn’t be in the sun anyways. SUNBLOCK cough.  It’s Sunny Out! (A Post in Honor of Sun Block).  Also, because of this photosensitivity don’t put these products on during the day.

A Client of Mine…

Came in for Botox and I couldn’t get over her skin. I asked her what she was using. She said to me, I’ve been using that cream I got from you once in the morning and once and night. The cream she was talking about was the Reconstructive Repair Crème with the retinol in it. Well…. she looked amazing, and thank god it was during the winter time and she wasn’t out in the sun! She also told me she always used the sunblock/moisturizer on top of the crème. I’m not recommending anyone do this! I’m just saying, it made SUCH a difference in her skin! I could feel the difference when I injected her. Of course, I told her not to do this in summer time. J Mistakes are how we learn!

Product
Spotlight!

Image Reconstruct Repair Crème:

A highly concentrated blend of retinol, glycolic acid and oil soluble Vitamin C to resurface, rejuvenate and repair aging skin. Leaves skin youthful, firm and radiant after just a few applications.

Reconstructive Retinol Booster:

Mix two drops with the Vital C anti-aging serum or the MAX serum as directed. Must not be applied directly onto skin without prior mixing! Use only at night.

Hydra-facials are awesome.

19 May

(after picture)

Because I’m pretty and I say so. And in case that’s not enough of a reason… read on. J

A Little Latin Lesson in Linguistics (alliteration is as awesome as hydrafacials)

In case you’re a little rusty on your Latin, “hydra” means water and facial means … well facial isn’t Latin for anything. That I know of… but I’m not a linguist. Anyways. Hydrafacials are amazing! They work by infusing serums into your pores. Hydrafacial, or hydradermabrasion, is a noninvasive, non-laser skin resurfacing treatment that combines cleansing, exfoliation, extraction, hydration and antioxidant protection simultaneously, resulting in clearer, more beautiful skin. There is no discomfort or down-time (although you might have a little redness for about an hour). The treatment is soothing, moisturizing, non-invasive and non-irritating. It also has attachments that can be used on the back, neck, and décolleté (that’s actually a French word… not Latin).

The HydraFacial treatment improves the appearance of:

  • fine lines and wrinkles
  • congested and enlarged pores
  • oily or acne-prone skin
  • hyper-pigmentation and brown spots

Before starting, I washed all of my make up off (which I don’t wear much of because my skin is usually so nice!). This is my before picture. I was in DESPERATE need of a facial.

Pass 1: Activ-4™ Skin Solution

Designed for most skin types. It helps to promote the overall health of skin; improve the appearance of hyperpigmentation, brown spots, fine lines and uneven skin tone. The tip attachment used on the hand-piece during this step has a fine sandpaper-like part works like microdermabrasion. It mechanically exfoliates the top layer of skin.

My face is RED.

The black part is the microdermabrasion tip.

Step 2: Beta-HD™ Skin Solution

This Salicylic Acid based skin solution is specifically designed for acne-prone and oily skin (like mine). It softens sebum, dislodges skin debris and aids in painless extractions of whiteheads and blackheads.

Step 3
Antiox-6™ Skin Solution:

Containing Vitamin A, Vitamin E, White Tea Extract and Hyaluronic Acid, the Antiox-6™ is designed for overall antioxdiant protection and deep hydration on most skin types.

Other Steps

  • DermaBuilder™ Peptide Complex (
    DermaBuilder™): THE new, hot age-refining solution right now! The DermaBuilder™ helps to improve the appearance of fine lines and wrinkles, skin firmness, skin tone and skin texture.
  • GlySal™ Acid Peels ( GlySal): This special Glycolic Acid & Salicylic Acid blend combines physical & chemical peeling to achieve optimal results. Unlike traditional acid peels, there is little to no downtime involved. Skin is well hydrated, smooth and radiant after the procedure.

1 hour later …

In the CAAAAAH Leaving JAHHHHR. Boston. Haaaaaa.

Representing my team. I love Rondo! #9 : My man.

Very happy my skin looks so good. Now if we could just fix my skunk hair. Just kidding. I love my Ombre (hombre? I think that’s Latin?). As you can see I’m still a little pink, but my skin looks and feels so fresh and so clean.

Recommendations

Visible skin refinement and an even, radiant skin tone may be seen after just one treatment. The smooth results and hydration may last 5 to 7 days or even longer.  A series of 6 treatments is recommended for improving the appearance of fine lines, wrinkles, hyper-pigmentation, acne and oily skin. Remember, using good skin care products at home will help these results last longest and help give you the most bang for your buck (did I just say that?) for any in office procedure. (Step 2: Spend wisely.)

I even got Alexis to love them (the Image Rep slash Skin Guru). And she is so picky about her skin. See. She’s smiling.

Under Eye Circles and Bags

16 May

Physiology: Broken blood vessels within the lower eyelid. A shadow forms underneath the bag causing the dark circles to appear. As you age, the “bags” (fat pads) can bulge due to gravity, creating an exaggerated space between the skin of the check, and the skin of the eye, over the orbital rim (bone of the eye socket). These dark circles can bring about a chronically fatigued look, or make you appear older than you actually are.

Cause: range from fatigue, vitamin deficiency, hyperpigmentation, allergies, age, and medical conditions. However, heredity is the most common cause for bags under the eye (also, from my patient’s personal experience… I hear children and husbands may also be contributors? It has not been clinically proven however.).

Treatment:

Getting the proper rest and eating the right foods can sometimes help treat and improve dark under eye circles, but if genetic, dark under eye circle will increase if untreated.

Fraxel®, Thermage®, Blue Light Therapy, IPL Photofacial, Dermal Fillers and Chemical Peels (like TCA). Patients with more severe cases of under eye circles, puffiness and loose upper or lower eyelids may want to seek out surgical alternatives including blepheroplasty.

My Best Advice

It is always a good idea to start with the least invasive methods and move on to the most invasive methods. That being said, genetics does play a HUGE role in this, and if your mom or dad has extremely sagging lids, or bulging fat pads, the earlier you do surgery the best result you will have.

Least Invasive to Most Invasive

  1. Hydration: The area of skin under the eye is the thinnest in the body. In a hospital setting, we monitor this area as a sign that a patient could be dehydrated. I can always tell when someone needs fluids just by looking at this clinical sign. Start with drinking water… water is good for your body all around. And… it’s FREE!
  2. Eye Cream: Supply your skin with the nutrients it needs. By depositing certain vitamins and peptides, you can decrease the appearance of dark circles. Before you tell me you’ve tried every cream under the sun… have you read my post on pharmaceutical products? Step 2: Spend wisely.
  3. Noninvasive treatments: Laser stuff. Not my area of expertise, however, I have had IPL on melasma, and it worked great. Laser treatments will help with the discoloration, and may subtly tighten the skin, but they will not fill volume loss. If you have volume loss, see step 5.
  4. Chemical Peels:  Best done in the winter time when you’re not in the sun.  And actually… this is more for fine lines and wrinkles around the eyes than bags and dark circles.  Although it will help the appearance.
  5. Dermal Fillers : (That’s NOT Botox..) A hyaluronic acid of low molecular cross linking like Juvéderm Ultra is most recommended for this area. Thicker fillers, like Radiesse, and biostimulators, like Sculptra, are not recommended for this area. Remember this skin is the thinnest in your body, and thicker products can leave bumps here. Be VERY careful about who you see for this treatment. It is a very advanced procedure that your Dentist or Primary Care probably shouldn’t be performing on you.
  6. Blepheroplasty: Check out my post on Blephs. Observing Surgery: Blepharoplasty.

Dermal Fillers

Dermal Fillers are my area of expertise (Remember photography is also not my thing!!!)

Here’s my Before and After Tear Troughs:


Before: I look tired. And old. Ew. Taken November 2011.


After: As you can see I look more awake and refreshed. Taken February 2011 after I had my tear troughs filled.

I am very happy I did this. Surprisingly, it didn’t hurt at all. The product used was Juvéderm Ultra. It will last about a year. Cost is about $600.

Creams

(The two I like best)

Image Max Eye Cream: This next-generation revolutionary day and night eye crème contains high concentrations of growth-factors derived from plant stem cells to protect skin cells and prevent aging effects caused by free radical damage. Reduces the appearance of fine lines and wrinkles; reduces puffiness and inflammation. Prevents cell aging. Contains grape, alpine edelweiss and apple stem cells for maximum age prevention. Corrective peptide blend for rejuvenation. Retails for about $45

Image Vital C: A scientifically- advanced hydrating, anti-aging eye gel. Contains a blend of nourishing anti-oxidants that reduce the appearance of fine lines and prevent the breakdown of collagen. Vitamin K  (Phytonadion) diminishes dark circles. Restores youthful looking eyes. Retails $31


Botox Before and After

9 May

I started doing Botox two years ago, at age 25, when I started my business (you know… injecting Botox). Personal experience has taught me a lot about the products I use for Aesthetic Procedures, and that’s why I make it a point to use all of them. Do I need them? No… Probably not (except the duck lips… those I need…). Are they hurting me? Definitely not, they’ve been around for YEARS (especially Botox).

Remember this face? How could you forget it? I look angry! (it’s from my post on facials). I clearly have needed Botox for some time.

I get migraines when I’m in need of Botox.

I look angry when I’m in need of Botox.

I need Botox.

…hey we all have our addictions right? J

Pre Botox

My Botox Injections

I get Botox in my forehead and glabellar crease. When I started, I got Botox every two months. Here’s my medical records for y’all as an example.

2/19/10    21 units Botox

4/20/10    21 units Botox

7/1/10        21 units Botox

10/15/10    21 units Botox

2/5/11        21 units Botox

6/12/11    35 units Botox (had my 26th birthday… started noticing forehead lines!)

11/10/12    35 units Botox

5/7/12        35 units Botox

**Remember, results will vary. Everyone has a different face!

If you keep up on your Botox, as soon as you have movement back, you will get more and more out of your Botox injections. Most people go down in the amount of Botox they require as well. My doses are minimal. Plus I like that zero movement look. Especially now that I don’t have my Barbie hair… I need to keep my Barbie face (in case you’re a new reader, I recently switched teams… I’m a brunette now).

The reason for this is called muscle atrophy. This process is a natural occurrence in other parts of your body as well. Think about going to the gym a bunch. You get huge muscles. And then you stop. Your muscles die from not being used. The body naturally metabolizes the muscle tissue. Same thing basically happens if you’re not using the muscles in your face. It’s not dangerous. It’s a pretty natural process.

I didn’t take a very good before picture of my forehead, but my glabella (area between brows) is pretty good.


Before


Post Botox Day 1


Post Botox Day 2

As you can see, it takes 2 days to really see a difference from Botox. Some people it kicks in later. I tell people it takes 2 weeks to see the full difference from a Botox treatment. If in two weeks you have not experienced the results you’ve been looking for (i.e. you still have too much movement) then the dose you were injected with was not enough. I charge by the unit, so if you pay by the unit, you will pay for additional units. If you pay by an area, you may wind up paying for an additional treatment as well. Be careful what you payyyyy forrrrr. You want to pay by the unit. Trust me.

And now that my Botox has kicked in, as you can see, I really can’t make that angry face. Makes me look friendly and approachable….


Post Botox Day 3

So I’m all smiles!

It’s a lot softer look than from before huh? But… I still look like me. All Smiles Baby!

Self Breast Exam

2 May

The focus of my blog is on aesthetic medicine, and in posts to come, I will be talking about reconstructive surgery post-mastectomy. Because this is such a sensitive issue, I thought the best way to discuss reconstructive surgery was to start with some medical information. Not all plastic surgery is done in the name of vanity. I think that it’s important to remember this. It is a major decision to have plastic surgery, and in the wake of such a difficult diagnosis, it is (I’m sure) the last thing on a woman’s mind to be booking, but I’m not sure it’s the last thing they think about. To many women, breasts and hair are a physical association of what makes them a woman.

I would venture to guess everyone knows someone who has been diagnosed with breast cancer. It is a very difficult and prevalent issue among women of all ages, races, and socio-economic classes. Detecting cancer early greatly influences outcomes, and therefore self exams should be preformed monthly.

Breast Examination

Visual inspection should be done with and without a hand mirror to check for changes in contour or texture.

Manual inspection should be performed to note any changes in thickness or lumps. It should be done both in standing and reclining positions.

 

 

When Cancer is suspected…

If cancer is suspected, a needle biopsy is performed to confirm the diagnosis by evaluating the tissue to determine if there are cancerous cells.

 

Treatment is based on many factors, including type and stage of the cancer, the cancer’s sensitivity to certain hormones, and the over-expression of a gene called HER2/neu. Treatment choice should always be discussed with a professional.

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