Tag Archives: aging

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 Juvéderm, 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, Juvéderm 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 Juvéderm 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 Juvéderm 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 Juvéderm. 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 Juvéderm 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

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Everybody’s Doing It!

29 Jul

“My wife’s into that Botox Stuff” – weird guy on the cape trying to give me vodka. ????

Anyways, it seems like everybody’s into “that Botox stuff.” But no one will admit to it!!! What’s the deal people? I mean… I fully admit to being an addict. I love my Botox! I guess I’m a little on the young side (although my birthday is coming up July 31!! Yeah!). So who exactly is doing this “Botox stuff”? Here’s some excerpts from my business plan on the “consumer profile” (I wrote this in 2009, so… there is updated information… but… I haven’t updated my stuff. I HATE making graphs on the computer… but if you gave me some colored pens and a whiteboard I would be ALL over it!).

Consumers

A survey by the Aesthetic Cosmetic Surgery Education & Research Foundation (ASERF), 2009, found the typical patient “married, working mother between 41-55 years of age with a household income of under $100,000.” These women were also found to be “health-conscious,” exercising, and eating right. Nearly 7/10 of the responders regard Botox and dermal fillers as an important part of their aesthetic routine.

Smart, health-conscious women ahhhhh? That makes me happy.

Age Distribution

Number of Procedures Performed in 2009, according to the ASAPS:

Injectables:

18 and under

19-34

35-50

51-64

65+

Botulinum Toxin Type A

12,000

371,501

1,256,608

734,751

182,098

Calcium hydroxylapatite

0

9,844

55,635

41,118

11,880

Hyaluronic Acid

3,919

168,629

604,262

420,069

116,159

I’m assuming any of these 18 and under year olds are using Botox for non-cosmetic use, or for correction of facial deformities. Or… they are on “Toddler’s and Tiara’s.”

Percentage totals of Number of Procedures Performed in 2009, according to the ASAPS:

Injectables:

18 and under

19-34

35-50

51-64

65+

Botulinum Toxin Type A

0.5%

14.5%

41.1%

36.2%

7.7%

Calcium hydroxylapatite

0%

8.3%

47.0%

34.7%

10.0%

Hyaluronic Acid

0.3%

12.8%

46.0%

32.0%

8.8%

Gender

In a recent survey by RealSelf.com, of the people who would get cosmetic work, the percentage of men is climbing. Ya, it’s true! Men are vain too! And not just gays! I was sitting in a bar eating by myself (yea… I was banished from my dinner party…) and I met a couple from New York. They were so much fun! The husband and the wife did botox… and they’ve been together for 12 years. And they still liked each other. And other people (like me) had a blast talking to them. …You know me and my tangents. Anyways. Good looking people are happy and stay married longer. I’m not sure if it’s true or not… I actually made that up. But men really are doing the “botox stuff”!

Would Get Cosmetic Work:

18-34

35-44

45-54

55+

Men

64%

67%

64%

47%

Women

82%

82%

80%

71%

From 2008-2009, minimally-invasive procedures increased 2% in the male market (ASPS, 5). And I assure you, it’s not just gay men doing this! I have a pretty large percentage (ok… I have a few) straight men doing this “Botox Stuff.”

                                Source ASPS, 2010 (8, 10)

Location:

The Northeast Region charges the highest amount in fees in the minimally invasive cosmetics procedures industries.

According to 2009 Regional Distribution Data by the American Society of Plastic Surgeons, New England holds 20% of the Botox market and 31% (the largest) of the soft-tissue filler market.

Percent of Total Procedures Performed by Region

Region 1 Region 2 Region 3 Region 4 Region 5
Botulinum Toxin

20%

14% 23% 15% 28%
Calcium Hydroxylapatite 35% 16% 20% 15% 15%
Hyaluronic acid 31% 12% 18% 8% 31%

Source: ASPS 2010 (15)

The Northeast Region has the highest percentage of filler procedures performed (we are Region 1). Midwest is the yellow region 2. Region 3 is light blue. Region 4 is greenish. Five is purple. Interestingly, the Noretheast and West Coast are comparable in the procedures performed. I wonder how much L.A. and New York skew that though. And Miami probably skews region 3. Just saying. Statistics are only as good as their interpretation.

Income level

Data collected by the ASPS in “Demographic Changes among Plastic Surgery Patients” demonstrates that income no longer plays a significant role in elective procedures (1). With the adjunct on patient financing options, the numbers continue to increase.

According to an Allergan Representative, the average income level for a Botox Cosmetic patient is $50,000 nationally.

Social Class

Middle to Upper Class due to income level.

Education

Education level has not shown to be a significant factor in market; however the consumer of the Northeastern market wants to be educated on products/procedures before undergoing them.

Ethnicity:

                Source: ASPS 2009 Cosmetic and Reconstructive Demographics

Most Commonly Requested Minimally-Invasive Procedures for Ethnic Patients

African-American

Asian-American

Hispanic

Botulinum Toxin Type A

Injectable fillers

Injectable fillers

Injectable fillers

Botulinum Toxin Type A

Botulinum Toxin Type A

Source: ASPS 2010 (17)

Boston Market

And I’m not talking about chicken. Finding this information was pretty difficult, but I think I know my market pretty well. If you are under 35, you are probably not thinking about Botox or fillers… but honestly you should be. Remember, volume loss starts at 25. Being preventative is super important, and will cost less and look the most natural in the long run. At the very least, please use medical grade skin care!

If you’re over 35, it’s a good idea to start with the area that bothers you most. Have a long consult with your injector. Work out a schedule/plan with your provider, and make sure you talk about prices! That plan should ALWAYS start with good skin care!!!

I know your mom might disagree… but…

If Everybody’s Doing It, Shouldn’t You Be Too?


xoxo,

LK

Ahhhh… Big Ange is getting the “Botox Stuff.” LOVE IT! (Ok… well maybe she’s not the best ambassador of the Botox Nation. When do I get a t.v. show?)

Things You Never Would Think To Find In A Girl’s Bathroom

6 Jul

How I’ve gone from your typical teenage girl to … an aesthetic specialist (for lack of a better term).

I remember when I moved into my first apartment in college, and I asked my mom for a make-up table, because there were 4 of us with one bathroom. I used to wear a lot of make-up. Case in point:

Summer of 2004. My candy raver phase? I guess. Over tweezed eyebrows. Check. Spots on my shoulder from too much tanning beds (which is actually caused from a fungus for all you spotted tanners out there… GROSS). Check. Face make-up too light. Check. Choice in jewelry… no comment. Oh. And I have roots. I think I might have been going to see Roger Waters with my college boyfriend. Man, college is a time for mistakes!

Hey, I also found my college bathroom circa 2004. (I am the original facebook generation… back when you needed a .edu to join).

UMASS. That should explain anything off you might see in this picture. But as you can see. Small space for four people. And a cat.

Anyways. Normal bathroom. Right? Also, I’d just like to point out that I used to eat nothing but candy. But I always brushed my teeth. As evidenced by me brushing my teeth

So I’ve gone from this:

To this:

Well… now fast forward 8 years. I wear very basic make-up that takes me literally five minutes to do, but in return I have the weirdest stuff in my bathroom repertoire! Used for purposes I’m sure very few could guess! So here’s an insiders sneak peak to my bathroom. I hope you find this as ridiculous (and funny) as I do. Welcome to the bathroom of a high maintenance princess.

Shot 1:

I took this pic a few months ago and sent this to one of my co-workers. I thought it was absolutely comical that I had this stuff on my bathroom sink counter.

I believe the tweezers were for applying fake eyelashes. I learned to stop tweezing my own eyebrows. Please refer back to the college years if you are curious as to why.

I suppose pliers wouldn’t be a strange thing to have in the bathroom. I’m not sure what you would actually use them for or how to actually spell that word… but I use them to take out my hair extensions if they’ve gotten a little loose. Not normal.

Revitalash I use to grow my eyelashes longer and stronger for lash extensions… and because sometimes I ruin my lashes with the strip adhesives. Gotta have lovely lashes.

Shot 2:

My make-up bag. Fake Eyelashes. Behind that… Fake hair aka Diva Weava.  I wouldn’t be a Barbie Doll if I didn’t have Fake hair.  And my fav hair tool: my pink GHD

That is a legitimate paintbrush in the middle there.

Shot 3.

Shot 4: Stuff that is Usually on My Bathroom Counter

  1. Baby Powder: for my roots because I only wash my hair twice a week.
  2. Dry Shampoo: because sometimes baby powder isn’t my scene.
  3. QuickTan: Because sometimes you have to go from white to orange in 20 minutes or less.

What I’ve Done.

And then I also did a quick draw a few months ago (back when I was blonde) on all the stuff on my face that was changed. It was kind of shocking to me. I wasn’t going to post it… because there are always people out there that like to tear you down. But I guess I’m somewhat amused by it. And comfortable enough to say, bring on the controversy.

            

  1. Botox in my Glabella and Forehead
  2. Lip Augmentation  Pucker-Up, Princess – Damn Sexy Lips.
  3. Sculptra to my temples
  4. Cheek Augmentation
  5. Eyeliner tattoo
  6. Eyelash extensions
    Lovely Lashes!.
  7. Hair extensions
  8. I have juvederm under my eyes as well.

No Surgery Needed!

“Plastic surgery and breast implants are fine for people who want that,

if it makes them feel better about who they are. But, it makes these people,

actors especially, fantasy figures for a fantasy world.

Acting is about being real being honest.”
Kate Winslet

Dear Kate Winslet,

I appreciate your support for people to make their own choices on

Plastic Surgery. I assure you, I feel great about myself.

More confident than Superman. Oh wait. Is he real?

Or is that part of my delusional fantasy world?

Is that sarcasm? Or real honesty?

XOXO

LK

Like my Patriotic Red Extensions from July 4th? Happy Birthday America!

Thank you for giving me the freedom to be delusional and honest.

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.

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!

Softening the Lines

10 Apr

P. is a 50 year old woman who has seen me twice over the past two years. To start, she had deep naso-labial folds that she hated. We first filled them with Juvéderm (which was my product of choice two years ago, but now I like Radiesse better for this area). We then did a little bit of cheek augmentation with a large syringe of Radiesse.

P.’s son is getting married and she wanted a little touch-up before the wedding. This is totally common with treatments (and weddings). Remember, any procedure should be done with plenty of time for healing to occur in regards to bruising or swelling.

Before


After


Again, remember, I’m not a photographer! The goal with P. was to soften the downturn on her mouth, the depth of her chin, and the depth of the NL fold.

Gravity…

As you age gravity causes several changes to occur in your face. The fat pads on which your eyes rest slides out from the socket and begins to bulge. At the same time, fat pockets in the cheeks break down in a known consequential manor. The combination of these two things and the pull of gravity on lax skin deepen the look of the nasolabial folds and add years to the face.

So What did I do?

As I said, P. and I have done a few treatments together before. We did the folds first, to fill the depth caused by lax skin and gravity, and then I did cheek augmentation. As I have become more advanced however, I have changed my practices to moving from the top of the face down (because of gravity) and from the most advanced sign of aging backward. I have found this to be the most effective way to treat aging. In retrospect I would have done the following:

  1. Cheek Augmentation

    By reconstructing the fat in the cheek area by filling it with product, this will decrease the laxity of the skin which forms the NL fold. I know women start pulling up the sides of their cheeks at around 30, wondering what a facelift would look like. Well this isn’t a facelift. It’s a laxity lift. (I made that up). It’s an improvement which will help me use less product in the laso-labial fold area. This means a better result AND less money. J


    **Do you do this in the mirror? As you can see, I don’t have much lax skin… from multiple procedures (cheek aug and ulthera mostly). But uh…. I do have roots. No one’s perfect! 😉

  2. Marionette Lines

    This is one of the most advanced signs of aging (because it’s the precursor to jowls). The marionette line starts from gravity pulling down the corners of your mouth and gravity pulling the fat down from the cheek. It’s just a big ol’ gravity mess! Pulling the needle around the corner of the mouth pulls up the downturn of the mouth.

  3. Naso-labial folds

    While this is the LEAST bad sign of aging, this is usually what women are drawn to fixing first. Depending on your age, and your current amount of fat in your face, and the money your willing to spend to have the best result, are all deciding factors on where to start first. Aging didn’t start overnight, and… to be realistic… one treatment isn’t going to restore the youthfulness to your face. Many women’s biggest fear is looking like a Desperate Housewife (fake and expressionless) but this is not the goal of aesthetic medicine. The goal is to restore and maintain your features.

“Softening P.”: A Maintenance Session

P. still had nice volume in her cheeks, and her N.L. folds still had some nice fill (1 year later). P. just needed a little softening to look her best.

X = needle insertion point

Line = needle direction of needle





  1. Mouth Corners
  2. Marionette Lines
  3. Lip line
  4. Chin Sharpening
  5. Jaw Softening
  6. Nasolabial fold softening

Again the Afters


This round of treatment was to soften and touch up. One large Radiesse syringe was used to treat 6 areas. The result is a softer looking face. There is not a HUGE difference in what P. looks like, but there shouldn’t be. Treating six areas with one syringe will not show a HUGE difference. Six syringes in 6 areas… now that’s a different story. Personally, I will only do ONE syringe at a time. Once you fill one area, you change the skin volume, and laxity changes. If someone tries to sell you six syringes at once, RUN. They are not looking out for your best interest, and you are going to leave the office looking like a different person (or something non-human!).

LK Signature Facelift: Giving Myself a Facelift

8 Apr

You have NO idea how hard it was for me to give myself the LK Signature Facelift and take pictures of myself at 9am. Ok, I admit, it’s not that hard. But still, I look pretty silly in some of these photos! … so I hope you appreciate them! Below are pictures and the steps in my LK Signature Facelift, including what each layer is and what it does for your skin. And also… in case you didn’t know… LK is my initials. 😉

So who is the LK Signature Facelift good for and what kind of result should you expect to see? The LKSF (my new nickname for it) is recommended for anyone and everyone! It is an especially excellent resurfacing treatment for those who suffer Rosacea. The LKSF can even be performed in conjunction with Botox and dermal fillers! After the LKSF, your skin will be tighter, lighter and brighter….who doesn’t love that?!?

ß (I need to touch up my Botox and that’s my “I need Botox” face)


Step 1: Cleanse

When I do this treatment on my clients, I use the Image
Ageless Total Facial Cleanser, which contains 12% Glycolic Acid. Glycolic Acid is excellent for exfoliating the skin, leaving it fresher and brighter looking! The Ageless Total Facial Cleanser has a great tingly feeling, so you KNOW it’s working! It is excellent for keeping pores clear and occasional breakouts to a minimum

I cleansed my skin with the Ormedic Balancing Facial Cleanser, it’s a gentle cleanser (Organic Aloe Vera is the first ingredient in this cleanser!). I didn’t feel like leaving my bathroom to retrieve my Ageless Total Facial Cleanser which is literally an arm’s reach outside the bathroom door. It was 9 a.m., people!

Step 2: I-PREP Degreasing Solution (Professional Only Product…btw)

The degreasing solution is applied with gauze. The reason degreasing solutions are used in professional treatments, is because we want to remove as much of the surface oils on the skin, as possible. This will allow for the product to evenly and more effectively penetrate the different layers of skin.

Step 3: Vitamin C Enzyme Resurfacing Solution (Professional Only Product)

This first layer I apply is the Vitamin C Enzyme Resurfacing Solution and it’s used to keep the pH of your skin high. The higher the pH of a product, the less irritating it is. Vitamin C is actually an excellent resurfacing agent and will help brighten your skin. Not to mention, your skin needs Vitamin C in order to form healthy new collagen! Collagen is what gives skin its healthy, bouncy structure.


Step 4: Resurface/Exfoliate



The Ageless Total Resurfacing Mask has smooth, little micro-exfoliating beads in it that gently exfoliate the dead skin from the top layer of skin (the epidermis). By exfoliating dead skin, your body is stimulated to increase it’s cellular turnover rate (In more simple terms, it makes new healthy baby skin cells, and the still healthy young skin cells are pushed up through the layers.) Can you see how the micro-exfoliating beads in this formulation are perfectly round? They don’t tear your skin (like certain over the counter “exfoliators” will, inviting infection into your skin… and also making your body work to repair micro-tares). The Image Total Resurfacing Masque is high in glycolic acid as well. It is one of my favorite products because you can use it as a masque or a scrub! Sometimes I even like to mix a little into my Ormedic Balancing Facial Cleanser for some added exfoliation.

I’m such a ham! A Kosher one…

Step 5: Blast of Nutrition


The Vitamin C Enzyme Resurfacing Solution is applied a second time…the point here, to add even more Vitamin C to the skin! Remember, tighter, lighter and brighter!

Step 6: Hydrating Enzyme Mask


This final layer is an active masque that eats up the dead skin cells that have been removed from your face with the other layers. The Vital C Hydrating Enzyme Masque is also one of my favorites because it injects the skin with hydration and antioxidants! My skin is always left looking brighter and more supple after using this masque…sometimes I even sleep with it on so I wake up looking super-hydrated and vibrant.

Step 7: Remove Layers

Using sponges and warm water all four layers are removed, leaving me with fresh, bright skin!

At home tip: You can do your own at home mini-LKSF. Start by cleansing your face with your favorite Image Skincare Cleanser. Then mix equal parts Ageless Total Resurfacing Masque and Vital C Hydrating Enzyme Masque. You can leave this combo on for up to 30 minutes. Then remove with a clean washcloth and tepid water. Next, apply your favorite hydrating Image Skincare serum, Image’s most popular serum is the Vital C Hydrating Anti-Aging Serum. Then apply an eye crème, like The MAX Eye Crème, uses the latest in cosmeceutical technology and breaks up blood pigment (dark circles) by up to 20%! Next you would apply either your favorite Daily Defense Moisturizer or Image Repair Crème. Finish with the Ormedic Balancing Lip Enhancement Complex, for the ultimate juicy, plump lip without that irritating bee-sting effect.

Image Skincare is only sold to licensed Skin Care Professionals, like me! So, if you are interested in purchasing some of these products for your own at-home use, contact me. I also offer free shipping!

Step 8: SMILE…

…because nice skin makes you happy! I have this facial done every other week in the summer… when I shouldn’t be doing as many chemical peels. It’s a nice gentle exfoliation. And off to work I go with no make-up on (I don’t know why I still look half asleep… oh maybe I do need some make-up…Flawless Foundation from Image Skincare is my fav!!!). Can you tell I love this line? Lol, I’m not the only one though. I think at some point I’ll do a testimonial’s post!

Master of Puppets

28 Feb

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

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

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

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

Can you fix it?

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

Before



What Needed To Be Done?

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

Marionette Lines

Prejowel lines

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


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


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

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

After

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

Side Note

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

*If YOU Are Considering Filler*

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

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

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

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

Ulthera – Skin Tightening Ultrasound Therapy

15 Feb

Ugh. Gravity.

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

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

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

Ultra Sound Therapy

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

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

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

Feedback

Does it hurt?

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

Is it immediate?

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

Is it for you?

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

Before and Afters

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

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

Alexis Before and After

Before

Immediately post treatment

24 hours later

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