Archive | Anti-aging RSS feed for this section
Video

High School Reunion: Look Better than You Ever Have!

12 Aug

or at least look like your Facebook photos!

image

Ok, so I haven’t yet gone to any of my reunions… I run into people from my High School every now and again (you know… While I’m Botoxing them in my office….).  It is always great to catch up with the people who knew you when… Unless you don’t like them.  Then it’s great to look better then they do.

As as for the ex-boyfriend factor… Personally, I ran into one of my high school ex’s recently… Ehhhh what was I thinking?!?!?!!!!!!  (Dad, you were right about all my boyfriends!).  Even so, it can’t hurt to look uber attractive at a big reunion.  I just picture Romy and Michelle… Inventing post-it notes.  Ugh… And that AWEFUL football player.  Insert theme music:  time after time.  Love that song.  Sorry… I digress!

A reunion is as good a reason as any to want to look good.  Feeling good about yourself physically boosts your positive self-image and brings out an all-around better you!  And what could be more attractive then that?

So get pumped, start that diet, buy some AMahZing shoes, check out my video, and make them jealous.  Or just have fun… 🙂

VBlog Reunion

Advertisements

Aesthetic Consultation: Botox and Fillers

25 May

What to ask for and expect during consultations for Botox and fillers. consultation video

Peanut Head: Volume Loss at the Temples

29 Jul

I’d argue the most over looked sign of aging is loss of volume in the temple. As we age, the temples lose fat and begin to narrow, shifting the balance of the face downward. Volume loss here contributes to the appearance of drooping and sagging of the cheeks and eyes (see Structural Changes in the Aging Face for other changes).  It begins as early as in your 20’s. It is most notable in athletes who have very little fat on their bodies, I’ve found especially runners.

As you can see, the area of total volume loss is pretty big when you actually look at it. In order to achieve the youthful contour of the temple, a patient will require a lot of product here. Adding filler to the temple is easy and almost painless, but deciding what filler to use can be difficult, they all have pro’s and con’s.

Juvéderm

This is usually my first choice with patients. For some reason… people tend to be nervous about filling this area! The great thing about JuvĂ©derm is that it’s disolvable. The bad thing about JuvĂ©derm is… you need a lot of it to fill this area, and that can be expensive. I’ve found great results by diluting the product before injection. The patient can see the result immediately. It may not last as long this way, but it is a good starting point. Most people love the result and usually step up to Sculptra when they notice they need a “refill.”


Radiesse

I personally don’t use Radiesse in the temples. It always reminds me of the scene from the Real Housewives of Beverly Hills when Adrienne Malouff’s husband injects Taylor and she has this big bump in her temple and Adrienne goes “is it supposed to look like that?” Although you get more volume with Radiesse, you also have more of a chance for lumps in this area. It’s not as smooth as JuvĂ©derm (which is literally defined as a smooth consistency gel). It’s just not my preference, but for extreme volume lost I can see it being more cost effective.


Sculptra

I personally have had Sculptra injected into my temples. Sculptra is not a filler, but a biostimulator. Over several weeks post injection it promotes collagen production. It may take more than one treatment (usually 1-3 vials 1-3 treatments) to achieve the desired result. This is the longest lasting, and most cost effective product if you consider the longevity, but up front can be expensive. If you are the type of patient who is doing multiple fillers at a time, you should probably step up to Sculptra.


Fat Transfer

Fat injections can also be used in the temples but are only cost effective if a large amount of volume is needed for the entire face. I recommend only allowing a plastic surgeon perform this procedure (although a nurse can do it in Massachusetts). The fat is harvested from another area of the body (usually the lower back) via liposuction and transferred to areas of volume loss in the face (usually not just the temple). There is a lot of swelling and bruising with this treatment and not all the fat will graft (stay alive after transfer). It is also an expensive and invasive procedure. This being said, it can yield great results for patients who really need it.


The Procedure

Numbing cream is applied to the temple. The product selected is mixed with lidocaine and deposited on the bone until achieving desired volume. There is very little pain associated with all injectable products. Bruising isn’t typical; however, there are many vessels in this area, so it can happen. Expected cost depends on the product selected, but expect to use at least 1-2 syringes during time of treatment.

Good luck!

Sun Block and Photoprotection

29 Apr

Everyone should be wearing sun block. But is that enough?

Prolonged unprotected sun exposure damages cell DNA. Not only does this result in premature aging, but can also cause melanoma and other skin cancers. I am a HUGE believer in wearing sun block (and not just in your make-up… that really doesn’t count).

When Buying Sun Block

If you’re not wearing it year round (which you should be), you should replace your sun block every year. Products can break down from heat exposure and from not being stored properly. It’s worth doing. You want to make sure you’re getting the best protection you can. Check your bottle for the following:

  • “Broad Spectrum” (protects from UVA and UVB light)
  • SPF 30 or higher
  • Zinc Oxide or Titanium Dioxide (physical blocks)

For more on sun block read It’s Sunny Out! (A Post in Honor of Sun Block).

Avoiding White Residue

I know people hate the white residue you get from zinc oxide or titanium dioxide, but these ingredients really are the best for sun protection. If you don’t like the white residue on your face, consider either buying a tinted SPF or buying a product that has a micro-ionized formula (smaller particles). I’ve found people really love SkinCeuticals Sheer Physical UV Defense SPF 50. It’s really light weight, doesn’t smell, and doesn’t leave a residue. The product retails for about $34, so it isn’t super expensive either.

C E FERULIC

While on the subject of SkinCeuticals products, and sun block, I have just started using their C E Ferulic serum. C E Ferulic contains ferulic acid, an antioxidant that doubles the synergistic benefits of C E – neutralizing free radicals, building collagen, and providing improved antioxidant protection. No other antioxidant technology has been shown to deliver comparable levels of photoprotection. This product has won multiple awards including:

  • Allure Best of Beauty Three-Time Award Winner Category: Best of Skin Care – Serum
  • InStyle Editor’s Pick – 2011 Best Beauty Buy Best Antioxidant Serum
  • NewBeauty – Beauty Choice Award The Best Anti-Aging Antioxidant Product

Although retinol (Every Woman Should Own A Retinol Product.) and sun block are the only topical products proven to prevent fine lines and wrinkles, I think a good anti-oxidant is almost equally important. For those of you who prefer not to use a retinoid in the summer months, C E Ferulic is definitely a good product to add to your beauty routing; it is outstanding in conjunction with sunscreen!

**Products can break down if not stored correctly (like I said before) and pharmaceutical grade products like C E Ferulic should never be bought online. Just like it’s worth it to buy new sun block, it’s also worth the few extra dollars to know your product wasn’t exposed to extreme temperatures, tampered with, or expired. Talk to a medical aesthetician if you’re interested in learning more about C E Ferulic!

Why Is Photoprotection Important?

Photoprotection is a measure of a product’s ability to neutralize free radicals and protect against oxidative stress (which can be caused by UV rays). Oxidative stress leads to premature aging, hyperpigmentation, and loss of elasticity… my three biggest fears!


Recent Studies Reveal We May Not Be As Protected As We Think:

  • People don’t apply enough sunscreen to achieve full SPF. Real-life application of an SPF 20 sunscreen yields an SPF of only 3 to 4.
  • Even when applied properly, sunscreens only block 55% of free radicals.
  • Considering what we now know about sunscreens, photoprotection is more important than ever.

The sun is stronger than it used to be, and protecting your skin is not an option. It’s time to add an anti-oxidant to your daily skin care regiment!


XOXO, LK

More Belotero!

27 Feb

Belotero: The Buzz.

Belotero has been my #1 selling injectable since it has been on the market (September). It gets into the small little lines that no other product really can with the natural result that Belotero offers.

The procedure I do the most? Under the eyes! It literally takes 10 years off your face! I might not be able to take away sleepless nights and stress, but at least I can make it look like I did by improving Under Eye Circles and Bags! I’m so thrilled with this product I did my own under eyes (called the tear trough). December was so busy and stressful, I was looking really tired. I did my under eyes about a year ago with JuvĂ©derm, but Belotero is much better designed product for this area (read why below).

Do you see how tired I look? (I hate sharing before pictures of myself with no makeup!)



A little numbing cream is put under the eye for about 20 minutes. Then the numbing cream is removed and the face is marked for anatomical landmarks. This is just how I mark the face. Other injectors might do it differently. I am also aware I need an eyelash fill REAL bad.


Looks so much better after!!! It didn’t bruise or hurt at all!



Look at my dark circles. They are TOTALLY gone. I swear I have NO advanced computer knowledge what-so-ever. These are straight off my phone!

Belotero vs. Juvéderm vs. Restylane

Why do I like Belotero under the eyes more than other Hyaluronic Acid (HA) products? Belo doesn’t have any hydrophilic effects (hydrophilic = attracts water molecules). Plus or minus a little bit of swelling, the correction looks the same the next day, the next week, and the next month.

JuvĂ©derm and Restylane are also in the HA family, but have a hydrophilic effect. This means the product will take on water molecules after it is injected, giving the area treated more correction over the next few days to weeks. Great for your lips and cheeks. Not great in the ultra thin skin under the eye. When this area is over treated you will see a bump or a bluish hue from the product. It’s not pretty. But it can be dissolved!  Hyaluronidase; Just In Case: injectables for beginners..

I also like Belotero because the product is thinner, which means it can be deposited in more superficial areas with a smaller needle and less pokes! Yay!

**Remember though: It’s the right product for the right place for the right person! Discuss which product is right for you and why during a consultation!  For more general information on which product is right for you What Goes Where?

More Before and After Pictures


The above patient had 0.2cc of Belotero to her tear trough area. It was two injections. The patient stated she did not even feel it (topical numbing cream was used prior to injection). The patient experienced no bruising associated with the procedure.

The above patient is a good candidate for filler in this area because the dark circles under her eyes are accentuated by a shadowing effect from volume loss. By replacing volume, the skin of the eye and cheek become more continuous as opposed to separate.


The above patient had 0.3cc of Belotero to her tear trough area. Topical numbing cream was used prior to injection, and there was no pain associated with the treatment. The patient experienced minor bruising the day after the injection which was easily covered with make-up.

The above patient would be a good candidate for a blepharoplasty. Although there is a clear demarcation of her tear trough, and filler drastically improved the area, the root cause of the delineation is not so much volume loss as it is a herniated fat pad. This fat pad is supposed to cushion the eye as it sits in the eye socket. Numerous causes contribute to the pad “bulging” out.

Interested in learning more about blephs?  Read Why I Chose To Have an Eyelid Lift.

The above patient had 1cc (1 syringe) of Belotero to her superficial marionette lines with great improvement to the texture of her skin. Topical numbing cream was used. The patient did experience some minimal bruising the day after the procedure. She is very happy with the outcome.


XOXO, LK

Above picture:

2 months after my Belotero treatment

3 days into the annual Cutera Conference in Las Vegas (so, I haven’t slept in 3 days)

1 week post break-up with my boyfriend

And still looking refreshed! Thanks Belo! Qué Bella!

(that’s Spanish I think…)

Belotero: The Buzz

18 Sep

I’ve been waiting to announce this for months!

Merz Aesthetics (the company that makes Radiesse) has released a new product: Belotero Balance. The product was FDA approved in November, 2011. Dr. Russo was involved in clinical trials, so I (of course) got a sneak peak at the product, and have been anxiously awaiting it’s arrival.

Why am I so excited you ask? Well, first, I think Merz makes awesome products (Radiesse is my favorite to use!). Second, and most important, this product can go into vertical lip lines! That’s right. No more “smoker’s lines!” I have SO many clients who complain about “smoker’s lines” around their lips!

Prior to this product’s release, there were two ways to treat the vertical lip line: with Botox or with HA Fillers.

Botox


  • Some people like it, some people don’t. I’ve personally never had Botox injected in my lips (I have however had many, many syringes of JuvĂ©derm), but I’ve been told it is a strange sensation. It feels weird to spit out your tooth paste, or use a straw, or kiss, because the muscle that is used for these things is “relaxed.” Obviously, you don’t want to relax it too much, or you’ll look like a stroke victim, so I’ve found it doesn’t last long in the lips.

Fillers (Juvéderm and Restylane)

  • As you can see from the picture below (this is a great example), by injecting product into the border of the lip (vermillion border), the vertical lip lines do visibly improve, but they are still there.

  • OR, you can have what I like to call “the monkey face effect” (I couldn’t find an excellent picture of this, but I’ve seen some real bad monkey faces. I would have tried to take a picture of this, but I’ve found people don’t respond well when you tell them they look like a monkey face from their filler. Or a cat face.)

Anyways, Back to Belo…

The Hyaluronic Family

Belotero is a hyaluronic acid injectable gel, like JuvĂ©derm and Restylane. Belotero more easily integrates into the skin and adapts to facial contours than other HA’s because it is softer. This results in a more natural and subtle look (but may require more product in some areas). Belo is designed to treat superficial facial lines and moderate to severe wrinkles that are closer to the surface of the skin. Unlike Belo, fillers such as JuvĂ©derm leave a bluish hue under the skin called the Tyndall Effect, when it is injected too superficially, like in vertical lip lines. Injections of Belo last up to 12 months, which is comparable to JuvĂ©derm (Restylane lasts about 6 months—does anyone even use Restylane anymore? Anyone?).

Belotero is made of sugars which naturally occur in our skin. No allergy test is required, and treatment is very safe. Like with all injectables, bruising and swelling are always a possible. My friend Colleen who is a dental hygienist is going to hate me for saying this again, but, for those of you in Boston who don’t tell anyone you do this stuff (even though EVERYONE does it) the best excuse for bruising is a “dental appointment.”

For fine superficial folds/fine lines. Including:

  • Periorbital folds or “crow’s feet” (also referred to as Periorbital lines)
  • Perioral Lines (aka Smoker’s lines)
  • Tear troughs
  • Deep forehead lines

For medium wrinkles, moderate-to-deep folds, lip contouring, and facial contouring. Including:

  • Glabellar crease, or frown line (the line that forms between the eyebrows).
  • Nasolabial folds, or smile lines (from the edge of the nose to the corners of the mouth).
  • Mentolabial crease, or chin folds (horizontal line that forms across the middle of the chin).
  • Marionette lines (from the corners of the mouth to the chin and jawline).
  • Earlobes (which of course aren’t in my picture! Oops!)
  • Lips and philtrum (which is the area between the nose and the upper lip)

(Do you like my feather lashes? I love Halloween Eyelashes!)

The world of Aesthetic Medicine is always changing. New products are being developed as we speak. For the latest info on the best new technology, stay tuned! I’m psyched for my newly approved Sientra Silicone Breast Implants! One more month until surgery!!!!

XOXO, LK

What Goes Where?

4 Aug

Prior to 2002, there was one type of facial filler: collagen. Many products have been developed over the past ten years which have caused collagen to become obsolete. There are now multiple categories of fillers, all made of different materials. The products in these subcategories have properties which make them better in treating some signs of aging than other areas or other products. Remember, fillers are different than Botox (it’s not all just Botox!). So what goes where?

Hyaluronic Acid (HA’s)

Synthetic forms of hyaluronic acid (a sugar that your body naturally produces) include products like JuvĂ©derm, Perlene and Restylane. HA’s increase fullness and enhance the viscosity of the naturally occurring hyaluronic acid in your body. Although it may cost a little more, JuvĂ©derm is currently the longest lasting product (in some cases lasts twice as long, and therefore is worth the extra $100 or so per syringe). I have performed over 200 JuvĂ©derm procedures, and have personally been injected with this product many times!

*note: My face is just a model, I haven’ had all this work done I swear! I just love “Paint.”

  • Best for superficial lines (not very deep, not folds).
  • They are used in areas where “plumpness” is desired (like your lips!)
  • They can be used in cheek augmentation, vertical lip lines, and nasolabial folds, but might not be the best product. Cheeks and Nasolabial folds typically require a lot of filler, and cost-effectiveness wise, this isn’t the product. But if you just need to fix a little sagging, it can be used in the cheeks. If you want to overpay for deep nasolabial folds, then this product also can be placed in this area.
  • Vertical Lip Lines are usually superficial, which would make JuvĂ©derm a good product, HOWEVER, if it is not placed right, the result is a monkey face.

Tips on Hyaluronic Acid

  • When I’m filling lines in the glabella, I always administer a dose of Botox to the area 2 weeks before injecting JuvĂ©derm. This allows me to inject directly into the line; it is easier to aim at a stationary target! How do you know if you will need Botox and Fillers? If you have a line in between your brows at rest (a “1”, “11”, or “111”) and you pull that line apart with your fingers, do you still see a crease in the skin? If yes, you need both, if no, Botox is enough.
  • I always apply numbing cream 20 minutes before injections.
  • I never inject too close to the outer rim of the eye (distal orbital rim), it usually irregularities in the contour of the face.
  • Injecting into the tear trough is a very advanced procedure. I can’t tell you how many times I’ve seen this area over filled (which looks TERRIBLE). My recommendation: it is better to under-fill and book a follow-up. This area requires a minimal amount of product, and my personal policy is to allow a client to come back at no charge if they require a small amount more (within reason).

Particulated Fillers

These products, like Radiesse and ArteFill, contain synthetic beads or particles in different liquid carriers. They last longer than HA’s, because the body doesn’t break them down as fast. They are also thicker than HA’s, which means they satisfy a larger area of volume loss. These products are injected deeper in the layers of skin (never superficially like HA’s are). Why? Because they’re made out of beads in liquid… and in superficial skin that would make bumps! This means they NEVER get injected into the tear troughs or into the lips. EVER. For very, very deep glabellar crease, Radiesse can be used (but usually an HA is a better choice).

  • These products are for moderate to severe volume loss. As you age, facial skeletal changes, general tissue volume loss, and the effects of gravity flatten out your cheeks. If you look at the contour of my face on right side of my face (your left), you will see how round my cheek is. I think you can see in this picture that the apples of my cheeks are round as well. A lot of women will look in the mirror at their nasolabial folds and want to go straight for filling only those, but that doesn’t give the youthful round shape back to the face. On some people I like to do cheek augmentation with Radiesse as well as nasolabial folds. I always do cheeks before folds, because the cheek bone is the scaffolding for the lower face skin. When you change that, the depth of the NL fold will also change. Always top to bottom, never bottom to top, when it comes to your face fillers! **When you have extra weight on your face, you keep the roundness. Skinny people have really flat cheeks when they age. HA. Take that skinny people.
  • The marionette lines, prejowel, and oral commissure are usually treated as one area that needs to be fixed. They’re kind of like vector components of each other (for all you Geometry dorks out there, *brushes shoulder off*).
  • Again, skeletal changes that occur as you age cause your chin to recess and along with volume loss, change the angles of your jaw and chin. This is another area a lot of people overlook when spending that quality time in the mirror pulling at their face in the “this is what I would look like if I had a face-lift” pose. Even if you do have a traditional facelift, you aren’t doing anything about the volume loss. This contributes to the unnatural look of a face-lift.
  • Radiesse and JuvĂ©derm can be used in conjunction to fix contour irregularities in the nose.

I hope that cleared up the two main classes of fillers. It’s a lot of information!!! The next post will be about Sculptra, which gets grouped in with fillers… but this is already too long! Lol.

xoxo SPRAY TAN – O – REXIC LK

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!.


ĂźAlexis 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.

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 ( ĂźI 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 (JuvĂ©derm, 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, JuvĂ©derm, 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 (JuvĂ©derm 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

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.

%d bloggers like this: