Archive | June, 2012

Prepping Your Skin for a Peel

28 Jun

It’s not exactly the best time of year to be doing chemical peels (or laser treatments) because most people want to be outside enjoying the sun. But I’ve been doing a lot of training with Alexis Robertson, the Massachusetts rep for Image Skin Care, and I just finished reading a book she gave me on Chemical Peeling. So I had to post something before I gave her back her book! Stay tuned for more posts on different types of Peels or start researching with   ‘Tis the Season for Chemical Peels!.


ßAlexis is peeling Andrea Purcell, an excellent aesthetician in North Reading at Stephanie Cogliano on Main Street. Andrea is a candidate for a peel in the summer because she has prepped her skin, and she will not be in the sun. She is a trained professional.

Why Peel?

Chemical Peels are great ways to reduce fine lines and wrinkles, clear up acne, and fade hyperpigmentation. But before you have a peel there are a few things you should be using on your skin to prep it. This will ensure you get the best results from your peel. Ideally, these products should be started two to four weeks before a peel, depending on the state of your skin to start and the type of peel that you will be receiving.

Prepping is important for several reasons.

  • It will reduce wound healing time.
  • Allow for more uniform penetration of the peeling agent.
  • Decrease the risk of post inflammatory hyperpigmentation.
  • Enforce the concept of a maintenance regimen and determine which products your skin tolerates.
  • Establish compliance and eliminate inappropriate peel candidates.

So what products should you be using to prep your skin? Here’s a little guide.

Retinoic Acid

(ex. Retin A, Trenitoin) By now you should know how much I love retinol! The use of Retinoic Acid 2 weeks before a TCA peel will speed up re-epithelization of cells (which prevents infection). Since Retinoic Acid thins the top layer of dead skin cells (stratum corneum), it allows for better penetration of the peeling agent. Retinoic Acid has also been shown to have some skin lightening effects. It is also my FAVORITE skin care product.  More on Retinoic Acid (my fav!).

 

AHA’s

(ex. Glycolic acid) AHA products also thin the stratum corneum and allow better penetration of peeling agents. They also have been shown to have some skin lightening effects.

*My Favorite Product EVER is an AHA/RETINAL Blend:


MD Reconstructive Repair Crème. Hands down best product on the market.

Bleaching Agents

(ex. Hydroquinone, kojic acid) These products are not exactly bleaching your skin. They inhibit tyrosinase, an enzyme involved in the production of melanin, making hyperpigmentation reactions less likely. Personally, I love kojic acid, it smells like Mexico. No, not the dirty part… the part that smells like Piña Coladas. We will from now on refer to this product as the Cancun of skin care. Minus the hangover.

Currently, there is some controversy over the use of hydroquinone. It should not be used for long periods of time, or on pigmentation that is caused by hormones (also known as melasma). Be careful with this ingredient. It’s used in a lot of medical product lines (like Obagi… which I’m not a fan of).

Sunblock

Get used to it. SPF BABY! Remember stick to physical blocks with Zinc.  It’s Sunny Out! (A Post in Honor of Sun Block).

So why is it important to establish a baseline?

By starting on products prior to peeling, a baseline can be established as to what your skin normally tolerates when it’s not inflamed or irritated. Also it establishes some good habits, like the need to wear sunscreen. If you go in for a peel, and you don’t wear sunscreen, you are going to be in some serious trouble. The same goes with using Retinol products. But, it all honesty, we sometimes ignore home care instructions because we don’t understand why we are being told we need to do something. We need a consequence before we follow a rule. Well… I forgot sunscreen one time while using retinol. I won’t do that again. Caused my own little chemical peel. Not pretty.

Noncompliance is a HUGE problem in health care. And chemical peels can be dangerous if you’re not going to listen to post care instructions. If you can’t follow a few instructions before a peel, you certainly aren’t going to follow them after. This just proves to you and your skin person that you are not an eligible candidate for a peel. But if you CAN follow instructions, it gets you into a good regiment which you will need to continue post peel. Remember, your skin cells are constantly cycling, and therefore it is extremely important to ALWAYS be taking care of them.

This is not a one and done procedure (like liposuction is… lol.).

“Youth No Longer Wasted On the Young”


Love LK.

P.S. I am sticking to being brunette. But I’m keeping my twitter name as @Boston_Barbie. I will forever be a blonde (and a child) at heart. You can follow me and Alexis at @ImageSkinCareMA.

Spray Tan Q & A

25 Jun

Spray tanning has become a hot commodity on the beauty block as of recent. So here’s some info for you about how to get that flawless, natural tan without being outside. I read a few articles online about spray tanning (and by online I mean the Patient Care Coordinator printed them for me. Thanks Buddy.)

After doing a little reading, I asked Lauren a few questions. She has started a business doing custom spray tanning recently, and is very knowledgeable about this hot new trend.

Me: So, I know I do this wrong, but how do you prep for it?

You need to exfoliate your skin and shave before you spray. Exfoliating is KEY and an oil-free exfoliant is reccomended for the best result. Do not use any deodorants, lotions, or perfume prior to your tan. Make sure to remove all makeup prior to the tan as well.

What gives a Spray tan color? How do you avoid the “orange” look?

The active ingredient in the solution is DHA (Dihydroxyacetone). DHA is an ingredient derived from sugar cane and is found in the majority of tanning products. It reacts with the amino acids in the uppermost layer of the skin to create the darkening reaction or tan.  DHA has been used safely in cosmetics for over 30 years. As the skin cells wear away, the color gradually fades just like a real sun tan. The type of solution you use will determine the outcome of the color of the spray.

How exactly does it work?

Whether you have it professionally done, do it at home yourself, or use an automated machine, it all basically works the same. A thin layer of solution is sprayed evenly over your skin. Over the next few hours your skin will get darker. It takes at least 8 hours for the solution to fully be absorbed into your skin and react with amino acids to create full color.  You may shower after 8 hours, but it is recommended to leave it on overnight if you can. The solutions come in different skin tones and you can apply multiple coats to make a person darker. A big trend is to add a shimmer to the spray.

How long does it last?

It can last 5-10 days, depending on how you take care of it. It’s important to keep your skin moisturized after your spray tan. Make sure to avoid long baths and hot tubs. Salt water or a chlorinated pool can also shorten your spray tan.

Is it safe?

The solutions used in most spray tan formulas, at home and in a machine, usually contain dihydroxyacetone (or DHA). Although there is controversy over how safe this product is, it is not a known carcinogen, and is considered safe to use topically. You should not breathe or ingest it. When used according to the FDA guidelines, spray tanning is perfectly safe. The spray tan consultant will have nose filters available for your peace of mind. Also, it is not recommended for children or women who are pregnant.

How much does it cost?

A can will cost anywhere from $10-$50 (but they are most likely to be streaky), a spray in a machine usually costs about $30, and to be professionally custom spray tanned is usually $45 (this gives the best result).

In Conclusion…/me ranting

There is some controversy over the portrayal of the “spray tan” as being a completely safe alternative to the tanning bed, especially when it comes to children and pregnant women, which most of the articles referenced. Hmmm… it comes from an aerosol can, and has a man ingredient with the suffix –acetone (dihydroxyacetone)… probably not something I would recommend pregnant women and children be sniffing… but… I mean… really? I think as long as your tan takes place in a well ventilated setting (or you at least hold your breath while it’s spraying your face) you should be ok. I speak from experience… I definitely sprayed myself in the bathroom with the door shut and started feeling light headed. But I was going from winter white to summer black (in 5 coats or less) to get ready for the Celtics game and I wasn’t thinking! Spray responsibly.

Obviously, pregnant women and those tiara toddlers should not be getting spray tanned. But the tanning bed alternative… WAY WORSE.

So that’s my two cents on studies that are “duhhhhh” and personally, I’ll take my chances with spray tan (aka fake and bake, aka tan in a can) any day! All the girls at the office are psyched to have this service available to us, and to our clients!

“A Penny For Your Thoughts,

Inflation Has Doubled,

And No One Wants Your Two Cents”

~My inspirational quote of the post.

Hyaluronidase; Just In Case: injectables for beginners.

15 Jun

I’m so good at rhyme. I’m just saying.

One in 5 women has interest in doing Botox, but has a billion questions, and it’s overwhelming. The inability to find the answers leaves this grey area of fear that supports a misguided rumor-mill of what Botox actually is. You can’t believe everything you read, and you certainly can’t believe everything you hear (unless I wrote it or said it. Then it is pretty much a fact).

‘The oldest and strongest emotion of mankind is fear,

and the oldest and strongest kind of fear is fear of the unknown.

-H.P. Lovecraft ( ßI wonder if his parents are from Amherst… strange name… but good quote none-the-less).

New to the World of Injectables?

Usually, the first place we go to is the internet, but when it comes to health-related issues, this is not the best place to sift through to find information without training in How To Read A Medical Article (this is an ENTIRE class, and it is REALLY hard). And unless your best friend is me… there is a lot of misinformation going around via word of mouth.

To those readers who have never done a procedure, it is all the same. It’s ALL called Botox. (That’s NOT Botox..)

 

It’s Not All Botox!

There are a lot of injectable products on the market, and the world of Botox and Fillers is doing nothing but growing. Every person has a different face and different goals with aesthetics. So it needs to be the right product for the right problem, and really only an expert can decide what that is. Since I love making charts, I made a chart of the basic differences between Botox and Fillers. That’s important to know.

***Super Important Information Chart*** for lack of a better title.

Botox (or Onobotulinum Toxin A)

Fillers

Injected into the muscle.

Injected into folds.

Causes temporary “relaxing” of the muscles into which it is injected.

Causes temporary fill of folds into which it is injected.

Does not give any volume to the face.

Gives varying degrees of volume depending on the product used, the amount of product used, and the area being treated

Goes into lines that are a result of muscle movement.

Goes into folds that are a result of gravity and bone remodeling.

Botulinum Toxin family includes Dysport, Xeomin, Reloxolin, but they all basically do the same thing (but are not interchangeable in dosage) and are injected the same way into the same place.

No one uses collagen anymore. These products are way more advanced. We’re talking Hyaluronic acid (Juvéderm, Restalyne) and Calcium Hydroxylapatite (Radiesse). Sculptra (although technically a biostimulator) is in this family as well.

Lasts 3-6 months.

Lasts 4 months – 2 years depending on the product.

Is a thin liquid when injected.

Ranges from a thick gel (Radiesse) to a thick liquid (Sculptra).

Usually doesn’t bruise.

May bruise, depending on things like the technique used for injection, the amount of product injected, the size of the needle used.

Pinches, but requires no anesthetic.

Requires both topical and local anesthetic. And even then isn’t always completely painless (depends on the area you are injecting).

As we can conclude from my awesome chart, Botox and Fillers are very different products. The left side of the chart is pretty straight forward. If the line is a result of muscle movement you can inject Botox to improve it. The Botulinum Toxin family has the same properties and effects for the most part… and 99.9% of the time you’ll be receiving Botox. It’s a household name.

Fillers on the other hand… way more confusing to the novice patient. To anyone who has never undergone an injectable procedure, they are all called “doing Botox.” But, once the decision has been made to investigate what all the hype is about, there is a very VERY steep learning curve. So where should you start then?

The Hyaluronic Acid Family

There’s a few different kinds of HA’s. Restylane, Juvéderm, and Perlene are all examples of products in the Hyaluronic Acid family. They are all very different as well. They can last from 4 months to a year (Juvéderm lasts the longest… and is currently the #1 seller of HA’s).

Hyaluronic Acid is a sugar that your body naturally makes that attracts water molecules. Everything your body naturally makes, your body also naturally breaks down. One of the best things about trying Botox and Fillers is that they don’t last, so if you decide you don’t like the result of a treatment, the good news is, it isn’t forever. Unfortunately, that is also the bad news. But for a beginner, there literally is a product that can dissolve any HA injection that is not to your liking. This is a huge positive for people who are new to fillers.

Fortunately for me, I’ve never had to use Vitrase. My policy on filler removal has always been to wait two weeks post injection and to re-evaluate the area. Swelling can last about two weeks, and I like to take this into consideration as well as the initial “shock factor” some people can experience.

Hyaluronidase is an enzyme that acts at the site of injection (i.e. does not travel systemically) to break down and hydrolyze hyaluronic acid. Tissue permeability is increased. There is a temporary decrease in the viscosity of the HA, promoting diffusion of the injected product and facilitating the absorption of the fluid carrier.

It appears from the case studies I’ve read that this product can be injected anytime after misplacement of HA’s has occurred. From immediately, to up to five months post injection. It takes 24 hours for a majority of the HA to dissolve post hyaluronidase injection.

****Why not always use HA’s? …because they’re more expensive. But remember: Right product, Right place, Right person.

The world of Fillers is expanding. There’s a handful of products out there, and they’re all formulated just a teeny tiny bit different. It’s not all Botox, and it’s not all the same. If you need a starting off point, because you just don’t feel comfortable with the information overload, HA’s are definitely the safest bet. Because they can easily be dissolved if you don’t like the result… but I’ll put money on the opposite happening. J

XOXO

LK

Why I Chose to Have a Tummy Tuck

10 Jun

The following was written by a patient who had undergone abdominoplasty. She is 40 years old, and had extreme weight loss resulting in extra skin. I think it’s also an important point to mention that she is recently divorced (which is stressful for anyone), and has been thinking about dating again (which is stressful for EVERYONE!). I am very thankful for her to share her story. There are tons of women who want to know more about this procedure.

Abdominoplasty

AKA “Tummy Tuck” is a surgical procedure used to make the abdomen more firm by removing excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. The wall is then stitched together making the abdomen more “tight” in appearance. This procedure is great for women who have had kids (they say you never can get your body back after children—”they” clearly haven’t heard of a good surgeon!) and for individuals who have lots of sagging, excess skin after major weight loss.


This procedure is sometimes also done in conjunction with liposuction of the abdomen. But not always. J

Why I chose to have a tummy tuck

I first considered getting a tummy tuck 2 years ago when I was going through a tough time in my life, thinking it might boost my spirits.  My weight had gone up and down for about 20 years and I had maintained a pretty substantial amount of weight for the latter part of those years.  I had just started to lose some weight due to stress and had talked casually to a surgeon about having it done.  He recommended I have a consult and that was as far as I got with it at the time.   

I thought I had made up my mind when I overheard a friend tell another friend that I was planning surgery for all the wrong reasons.  Something in me snapped and I decided against surgery.  I contacted a personal trainer and started on a plan to lose weight and get in shape.  It was not easy.  I had never been one to exercise and it took me a long time to start choosing the right foods.  The same patterns continued where I would lose some weight, but then put it back on.  I was getting frustrated and knew I had no one to blame but myself.  I continued to work out and eat better but I just couldn’t seem to move forward.

A few months ago I saw the same surgeon who told me I should have the tummy tuck.  He knew I had been working out and eating better and I didn’t look much different.  I took his advice this time and had a consult.  What I learned was that I had loose skin that was never going to get smaller with diet and exercise.  On the contrary, the more weight I lost the more loose skin I had.  It got to the point where I felt like it was both mentally and physically holding me back.  I decided to do the surgery.  The hardest part of my decision was telling my personal trainer.  I was afraid he would think I was taking the easy way out and I respect his opinion.  He was great!  He didn’t realize I was dealing with excess skin and he was very supportive.  He asked me a lot of thought provoking questions to verify that I was doing it for the right reasons and he gave me his blessing.  I thanked him and told him I would see him 6 weeks after surgery.

A week before surgery I had a pre-op where they took photos and went over my health history.  Other than the excess weight I was extremely healthy and a good candidate for surgery.  I was a little nervous, but mostly about the recovery.  I wasn’t nervous about the surgery, just about how I would feel afterward.

The morning of surgery I got up early and went to the hospital.  I was greeted by the wonderful nursing staff and then by my surgeon.  Lastly, I was introduced to my anesthesiologist, and that’s where it all becomes fuzzy.  The next thing I know I was waking up and the nurse said hello to me.  My response: Am I skinny now?  She laughed and told me I was.  I was in the recovery room for a short period of time and then two nurses wheeled me to my room.  My only discomfort at this point was bladder pressure (they adjusted my catheter and all was fine) and my back was sore.  Once I was able to adjust myself on the bed I had no discomfort. 

I opted to stay overnight in the hospital and I am glad that I did.  The nursing staff made sure I got meds on a regular schedule and I felt comfortable knowing I had round the clock care.  I had a few visitors who came and made sure I ate and that I was recovering well.  When the nurse came to give me pain meds I asked for Motrin instead.  I had zero pain, which was unexpected, so I didn’t feel the need to take narcotics.  I spent exactly 24 hours in my hospital bed and barely moved a muscle.  I wasn’t sure what to expect with movement so I decided to wait until the next day to move around.

The next morning the nursing staff asked me if I wanted to get out of bed and walk around.  I had them remove my catheter but told them I wanted to wait to get out of bed.  As soon as they left I got up on my own.  I don’t know why.  I think maybe I wanted to know I could do it on my own.  I walked to the bathroom and washed my face and brushed my teeth.  I walked back to the bed for a half hour and then got back up to get dressed in anticipation of going home.  Imagine the surprise the nurses experienced when thy came to check on me and I was dressed and ready to go!  No discomfort!  My only thought was to stay hunched so I wouldn’t compromise my stitches.

My friend, coincidentally a nurse, came to pick me up around noon.  They wheeled me in a wheelchair to the car and I very carefully climbed in.  I was tired but otherwise felt good.  The ride home was uneventful.  I got home and slowly walked upstairs to my bedroom, knowing I would be staying there for a few days while I recovered.  The doctor had told me to get up and walk around a little bit, but only as needed.  I had 2 drains that would let him know if I did too much activity.  I had another nurse friend stay with me the first night home but after that I felt like I could manage on my own.

I was a pretty good patient, or so I thought.  I felt great so I ended up walking around more than I was supposed to.  I washed my hair every day and fed my cats.  When I went for my post op appointment 6 days after surgery I got bad news.  My drains were pulling in too much fluid which meant I couldn’t have them removed.  I was put on bed rest and told to come back in 2 days.  Lesson learned.  I stayed in bed for the full 2 days, only getting up to go to the bathroom.  It worked.  I had my drains removed 2 days later and went back to work 3 days after that.  The removal of the drains was a source of anxiety for me but I barely felt them being removed. 

For 6 weeks I kept my activity to a minimum and followed all my surgeon’s instructions.  I asked the surgeon why I had such a great experience and he said it was probably because I was in shape from working out so much.  My recovery was not exactly typical.  I was a bit tired from the anesthesia but otherwise I felt pretty good.  Physically, I looked a bit out of proportion as I had a lot of swelling but over time everything evened out.  I am now 3 1/2 months post surgery and I couldn’t be happier with my decision.  I am back to the gym and I am now focusing on other areas of my body that need attention.  It’s been a long road but a trip worth taking.


Before and After

Also, check out how hot those panties are!


Before


After

A Note from Me

Sometimes I wonder if people understand that not all plastic surgery is done by super vain and “plastic” looking people. There are many different types of people who undergo the knife each year for reconstructive purposes and to fix something that has affected their self image. Case studies are the best! You should always talk to people who have done the procedure before (unfortunately most people who are elated with results from plastic surgery aren’t usually telling the world their secrets) so here’s some advice from Joan Rivers, Do Whatever You Want, If It Makes You Happy. But First Take This Quiz..

On a serious note, surgery IS serious and if you’re  Thinking about a NoseJob/Breast Aug/Lipo/Tummy Tuck? … Butt Implants?. you should have the list of questions printed from the blog entry to ask your doctor.

I would also like to remind patients NOT to get out of bed without assistance post-procedures. If you are on narcotics (which you probably still have in your system post-op) you are more likely to fall. And then the nurses have to fill out paperwork and it’s REALLY time consuming. Also, if you ever stand up and you feel dizzy, do NOT look down. Those are my words of wisdom for today.

Thanks!

-LK


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