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Retinols. Because I love them.

4 Nov

Retinol products are the best topicals as long as you use them safely. This means under the guidance of a skin care professional.

I start with my secretary voice… I’m nervous. Video blogging is hard!


Introduction to Good Skin Care Products

4 Nov

Just because something is expensive doesn’t make it work. Add a pharmaceutical skin care product into your home care regiment. You will see a huge difference in your skin!

I’m kind of ranting… and the lighting is bad. Sorry!


Patient Treatment: Botox

4 Nov

Botox is increasing in popularity amongst professional, straight, male clients, such as this patient. I have many male patients who do a variety of jobs including construction, roofing, psychology, sales, and business owners.
Finding one of these men to be on a Youtube video was easier than I thought!


Botox 101

4 Nov

An introduction to Botox. What it is and what it isn’t.

Video Blogging… It Starts…

4 Nov

Here’s my first video blog!

Hyperhidrosis – Botox for Armpits

10 Jul

Botox isn’t just used to make you look pretty. It is approved in over 85 countries for over 25 different clinical indications. In the U.S. it is also approved for migraine headaches, cervical dystonia, blepharospasm, strabismus, increased muscle stiffness in elbow, wrist, and finger muscles in adults with upper limb spasticity and symptoms of severe primary axillary hyperhidrosis.


Hyperhidrosis is a condition characterized by excessive sweating, where patient’s sweat up to 5 times more than a normal person. It can be generalized to the whole body (usually secondary to another condition) or localized to a specific area, most commonly the hands, feet and armpits (where there are relatively high concentrations of sweat glands). Although the cause of localized hyperhidrosis is unknown, it is contributed to an over-activity of the sympathetic nervous system. If you have this condition and you get nervous or excited, you’re nervous system is going to cause you to sweat even more.

Severe Primary Axillary Hyperhidrosis

Severe underarm sweating may be exacerbated by stress, emotion or exercise, but often occurs spontaneously. Botox injections were approved as treatment in this area by the FDA in 2004. The effects of treatment are temporary, lasting approximately 6 months. The treatment is used as a last resort when topical medications are not effective. It takes a lot of Botox to treat this area, about 50 units in each armpit, which costs approximately $1,000 -$1,500 depending where you go.

Although Botox is not approved for hyperhidrosis of other areas, that doesn’t mean it won’t work in that area. It is just considered an off-label use. A lot of bartenders Botox the palms of their hands so they don’t sweat. Personally, I’m considering Botoxing my feet. My roommate has several times given me some sort of foot deodorizer as a gift… and she constantly complains about my gym sneakers. I’ve also been known to track foot powder through her living room… Yea… I guess my sweaty feet are a problem.

The Injection Process

The armpit, as most of us can attest to, is a VERY sensitive area. Numbing cream should be applied about 20-30 minutes prior to injections.

Sometimes you can see the sweat glands, it’s usually marked by the hair follicle, but this particular patient had previously had laser hair removal. So I used a powder to help me see where the sweat gland was. As you can see, several rows are injected. A very small amount of product is deposited into the sweat gland at each injection site. The whole process is very fast once it is started; it takes about 10 minutes to do each underarm.

Don’t sweat it.

Happy Summer Everyone! Remember you’re awesome hat and SPF!!!

In Another Dimension…

24 Jun

Lips are the focal point of the lower third of the face. Full, beautiful lips with a well-defined contour have endured as the “ideal” image. Cultural and individual impressions of perfection are then based off this concept. Our culture currently values the sexy, full “Angelina Jolie” style lip, which VERY few people naturally have.

Lip augmentation is very popular amongst all ages of women, whether it is to make a fuller, sexier lip or it’s to restore lost volume due to aging. While some clients want to have a “ducky” result, some want a “pouty” result, and some just want to keep their current look but add a little volume. While it would be great if you could achieve the look you want with filler, some parts of the lip cannot be changed. So what kinds of things can be changed when it comes to the lips? And what can’t?


Dimensional Analysis

It all comes down to math… ick. So basically, the dimensions of anything 3-D are width, height, and depth. And if you multiply all 3 you get the cubic volume (I think… anyways… it’s really irrelevant for this blog post).


This is not a characteristic of lips that can be changed with filler. The width of your lip is the width of your lip. According to research on Clinical Facial Analysis, the average width of an attractive mouth is 50.9mm. I mean… to be specific.

The width of the lips is evaluated along the middle of the pupil line.

  • Large: lip corners extend outside the borders of the pupil
  • Medium: lips end at pupil
  • Small: lip corners are within the border of the pupil

The width of my lips technically is considered small for my face (in my defense though, I have unnaturally large eyes). Here’s a shocker: Julia Roberts has lips of a large width.


The thickness of the lip is measured from the top of the “Cupid’s Bow” to the change in contour of the lower lip.






The thickness of the lip is determined to be thin, medium, thick, or very thick depending on this distance. The height of a lip can be augmented, but subtly, by adding volume.





Many people lack fullness in their lips. Collagen loss and structural changes in the teeth and jaw cause flattening of the lip. But don’t worry, this IS something you can fix with filler. Volume gives the appearance of a “pout” (aka “trout pout”), which most people consider sexy at varying levels.






As you can see from this example (hopefully!) is a little bit of volume and depth in the lower lip, giving the more “pouty” look. By giving this patient volume in the top lip, there is a more defined contour to the border of the lip, which is also considered an attractive quality.

Ready for Augmentation?

If you’re sick of buying lip liner and plumping glosses which don’t deliver the result you want, smudge easily, and don’t last long, lip augmentation may be a good option for you. Achieving a look that is universally attractive and personally desirable can be done with filler. Make sure you have realistic expectations from where you’re starting from and what you expect your end result to be. Not everyone can have Angelina Jolie lips…. or mine 😉 !!!

Remember, no one’s lips are perfectly symmetrical. You can’t change the width of your mouth nor can you change your shape drastically in one sitting (so, as much as you might want to bring a picture and say: “I want to look like this”…. don’t do it!).

Hyaluronic acid products are ideal for lip augmentation (ie. Belotero, Juvéderm, Restylane). NEVER inject a thick product like Radiesse in the lips.

Take pictures of yourself before, that way you can see the difference!

Interested in learning more? Contact me for more information at (508) 309-9233.

Understanding The Differences In Skin Care Products

29 May

Great article!

Q. What is the difference between over-the-counter skin care products and medical strength skin care? Julie, Warsaw

 A. Julie, every day we are inundated with television commercials, magazine ads and marketing materials tantalizing us with the latest wrinkle cream promising to erase our lines and restore a youthful glow. It is easy to become lured in by the beautiful models perfectly airbrushed or the voice on the commercial touting impressive claims. While there is nothing “wrong” with over-the-counter products, their active ingredients are just not as strong as medical strength or cosmeceutical products. They are just not allowed to be. Less active ingredients equals less results.

When you are trying to treat and repair skin conditions such as brown spots, fine lines, acne and more, it is essential to treat below the surface of the skin down to what is known as the dermis. The trouble with over-the-counter…

View original post 477 more words

Trying New Products

27 May

Just like tissues come in the brand “Puffs” or “Kleenex,” there are different brands of products used in aesthetic medicine.

It is very difficult for patients to determine which product is right for them without consulting with a professional… and some professionals only use certain brands of products. I’m very lucky that the office I work with (and a lot of my patients!) let me experiment with different brands.

Right product, right place, right person!

Currently, I’ve been experimenting with different brands of Hyaluronic Acid Fillers (Juvéderm, Restylane, and Belotero). I use these products in tear troughs, temples, lips, vertical lip lines, marionette lines, nasolabial folds, and cheeks. They are not for large areas of hollowness (Radiesse and Sculptra are more cost effective choices). HA’s are great to experiment with because they can be dissolved if you don’t like the result. If you are a virgin to fillers, these are a good idea to start with.

Kiss, Kiss.

We all know I love Belotero under the eyes, and I almost always use this product for tear troughs (More Belotero!.)  The only time I use Juvéderm is for patients I think really should be getting a blepheroplasty…but aren’t ready to go under the knife (Observing Surgery: Blepharoplasty.)  But what about the Lips? ….Well it depends!

The Patient’s Concern

Bigger, Fuller Lips

Juvéderm remains my go to product for lip augmentation. It looks and feels the most natural (when injected right!), and is FDA approved to last up to a year.

I have found a place for Restylane in my heart recently, however. I had my vermillion border injected about 3 weeks ago, and I love it. This product really defines the border of the lip!

Vertical Lip Lines

For women trying to treat vertical lip lines, or “smokers lines,” I have mixed feelings on using HA’s vs. Botox. I usually tell people to try Botox first. Over treating the upper lip with a hyaluronic acid can create a “monkey lip.” It doesn’t look good! I’ve seen this happen a lot with Restylane and Juvéderm.

While Belotero is a good product to treat these lines, I’ve found the results don’t last long when I mix the product with lidocaine (local anesthetic). The lips are VERY sensitive, and require some sort of local and injected numbing agent (anyone who disagrees with this has never had their lips injected—it’s a lil pinchy).

My technique is to use both Juvéderm and Belotero. As you age, you loose collagen and the shape of the jaw and teeth changes. This causes an elongation of the upper lip. If you look really closely at an angle there is a horizontal ridge above the lip line. I fill this ridge with Belotero. The lips also begin to thin as you age. Juvéderm into the wet/dry border replaces this volume loss. I have found it can improve vertical lip lines when injected into the vermillion border and manipulated into the vertical lines. It may not completely get rid of them, but it will improve them, and it looks very natural (not like a monkey lip).

Downturned Corners

Changes in the shape of the jaw and gravity causes the corners of your lips to turn downwards as you age. By giving support to the lower lip in areas of volume loss, that from can be turned upside down before it turns into a full out marionette line (which Radiesse is the best for!).

To read more about lip augmentation check out Pucker-Up, Princess – Damn Sexy Lips.

Love Big Lips!  Lips, Lips, Lips!.

Holiday Wish List

27 Nov

So I was asked to make a list of the things I want for the holidays. I was told to make sure it was not ridiculous. I considered it a challenge to be completely obscure. (Followed by things your girlfriend/wife/daughter/sister might actually want this holiday season.)

  1. My first answer to this was a football helmet full of cottage cheese. If you saw the popular 90’s movie Airheads, you would get this obscure reference. If you haven’t seen it… you should.
  2. A day off. Oh wait… You don’t get those when you have a business. Grrrrr…
  3. New boobs = Need new bras.
  4. Office Space. Actual office space. In the Quincy area. Not the movie Office Space. Although also a great movie with a TON of awesome obscure references. Have you seen my stapler?
  5. New Louboutins. Because I love obnoxious shoes.
  6. A new car. Preferably of the Mercedes variety.
  7. Gay Personal Assistant/Gay Best Friend (GPA/GBA) on payroll. Not only to help me with my business… but sometimes I don’t know which shoes to wear. Also, sometimes he should not wear pants. Because, lets face it, Gay men always have better underwear than straight men.
  8. A dog. Which my assistant will also be taking care of. He told me he will not take care of a pig named “Kosher” or a piranha named “Nemo.” Which I accept, because I’m not sure of the legal status of these animals in the State of Massachusetts.
  9. My significant other to finish law school. Because I have obscure legal questions like “what is the status of having a pig or a piranha for a pet?” and “is ‘I thought speed limits were suggestions’ a viable defense?”
  10. A $10,000 gift card to Starbucks. My CPA, Matt Traiger, told me I have a problem. And I’d like a gift card for gas. I’ll take that in the amount of $25,000. Or I’ll accept stock in Exxon/Mobile.
  11. The Helicopter button in my new Benz. You know, the one you press so your car can fly over 93 when it’s gridlocked. Oh right. That’s EVERYDAY.
  12. An alarm clock that is also capable of removing me from my bed. And putting me in the shower. And cooking. And cleaning. Oh wait… maybe my GPA can do that. Or at least hire people to do that stuff.

I don’t think this stuff is TOO much to ask for.

Ok, but for REAL:

Cool Gifts This Season

Having a hard time finding the perfect gift?  Here’s a few things every female fancies (you can’t go wrong)!

Cute Boutique-y Jewelry? I recommend:

Gift Certificates For:

  • a manicure/pedicure ($15-$50)
  • a facial ($45-$150)
  • her favorite hair salon (be sure not to get just ANY salon)
  • a massage ($60-$100)
  • a day at the spa
  • A nice robe/winter gloves/hat/scarf.  We all wear them… we can always use a new one.
  • This is cool from Target (it said over 3,000 participating spas, but I’m not sure which ones):

  • A Little More Thoughtful:
  • A New Flat Iron (some good names: GHD, CHI, and BaByliss) ($150-$350)
  • Good Shampoo (like my personal favorite, Melu by Davines ~$26.50/bottle )

  • a subscription to New Beauty Magazine ( LOVE IT! $9.99/issue
  • NARS Turkish Delight Lip Gloss–looks good on literally everyone (Sephora $22)
  • Along the lines of Sephora (which is at every mall) there are some really cool, easy gifts in there.  I love their kits of things like “mascara’s” and “lip glosses.”
  • New Make-up Brushes (check out Sephora again)
  • Jewelry- but beware– jewelry is a very personalized gift.  Diamonds and pearls are always classy… but is she a diamond girl?  bling bling? or more subtle? like classy pearls?  Does she usually wear gold? or silver?  I once broke up with a guy who bought me aquamarines for an anniversary gift (not because I’m shallow, but because after dating someone for a year, you should know what kind of jewelry that person wears.  I realized it was a dead end relationship.)
  • Lulu Lemon.  For your sporty chick.  (Has anyone seen the commercial where the chick is talking all about why she wears yoga clothes–she bikes, she does yoga, she hits the gym– and then she says “Who am I kidding, I wear Yoga pants because I’m lazy” ahahaha)
  • The circle scarf. Very comfy. Very stylish. Check out these deals at

Just So You Know…

Bags–A crash course

  • Dooney and Bourke (otherwise known as D&B) $$
  • Coach $$$
  • Chanel/Gucci/Burberry/Louis Vuitton $$$$$$$$$

Don’t even think about buying her shoes. — however the book “100 Shoes: the Costume Institute/the Metropolitan Museum of Art” with intro by Sarah Jessica Parker… that’s a great gift!

100 Shoes: The Costume Institute / The Metropolitan Museum of Art

Ask a Chick!

My friend Megan swears by “asking Steph at Nordstrom’s in Natick;” all you need is a size and she can style you up (remember to check the tag of your girls clothes… and also keep in mind every brand is different, confusing and annoying–yea we know!).  If you can’t make it to Natick, that’s ok.  A lot of the high end stores have staff that are MORE than helpful.

Wrap It Up. 

Gifts should come in an exciting box.  So, wrap it up!

Happy Holidays! ~ LK

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