Tag Archives: product review

Juvederm vs Restylane for Lip Augmentation

9 Feb

Trying to decide which product you want to go with for lip augmentation?  Check out this post!  

For more basic information:

Lip Augmentation: Basic Information for Patients.

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Safety during Pregnancy: What You Should and Shouldn’t Include In Your Beauty Regiment

6 Sep

It seems like it’s in the water with co-workers and friends (as evidenced by the three pregnant ladies to the left from Sylvestre Franc). I’ve had a lot of questions about what is and isn’t safe to do when you’re pregnant in regards to skin care products, laser, and injectables. It is understandable that women want to look their best during this time and hormonal changes during pregnancy can sometimes result in acne, unwanted hair growth, melasma and other skin problems. So what is safe to use and what isn’t?

Not surprisingly (to me anyways), there really is not a lot of information on product safety during pregnancy. The FDA rates products on their risks during pregnancy as follows:

Rating Definition

A

Controlled Studies Show No Risk.  Studies in pregnant women show the medication causes no increased risk to the fetus during pregnancy.

B

No Evidence of Risk In Humans.  Studies in pregnant women have not shown increased risk of fetal abnormalities despite adverse findings in animals or in the absence of adequate human studies, animal studies show no increased fetal risk.

C

Risk Cannot Be Ruled Out.  Studies are unavailable and animal studies have shown a risk to the fetus or are also lacking. There is a chance of fetal harm if taken during pregnancy but the potential benefits may outweigh the potential harm.

D

Positive Evidence Of Risk. Studies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy may outweigh the potential risk such as in life-threatening situations.

X

Contraindicated In Pregnancy. Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. The use of the product is contraindicated in women who are or may become pregnant.

Skin Care Products

Most skin care products fall into the Class C category; however, some products are recommended by doctors not to be used during pregnancy (although there is not enough evidence for or against them).


Not Recommended:

  • Retinoids
    • In A Practical Guide to Dermatological Drug Use in Pregnancy (Zip, MD, FRCPC) category B topical such as erythromycin, clindamycin, and benzoyl peroxide were recommended over topical tretinoin. This study states reports of congenital malformations in infants whose mothers used tretinoin during the first trimester.
    • This ingredient is found in anti-aging products such as moisturizers, and acne products.
    • Chemically a form of vitamin A, which in high doses can cause birth defects.
    • Oral retinoids, such as isotretinoin (Accutane, an acne treatment), are known to cause birth defects.


  • Beta Hydroxy acids (Salicylic Acid)
    • Ingredients used for their exfoliating and acne-treating properties. They penetrate deep inside the pores and clean out excess oil and dead skin cells that can clog pores and cause acne, blackheads and dull-looking skin.
    • High doses of the acid in its oral form have been shown in studies to cause complications and birth defects.
    • Small amounts applied topically are considered safe (over the counter face wash for example), but peels containing Salicylic Acid are not considered safe when pregnant.

  • Hydroquinone
    • Clinically used for pigmentation for conditions such as melasma, and it is used cosmetically as a skin-whitening agent. Although a large percentage of this topical agent is systemically absorbed, the use during pregnancy does not appear to be associated with increased risk of congenital defects. This finding, however, is based off one study, with a small sample size (so it is recommended to avoid hydroquinone during pregnancy).


Safe

  • Vitamin C, Glycolic acid, and Lactic Acid: derived from fruit and milk sugars, considered nontoxic.

  • Hyaluronic Acid. This is a product your body naturally produces (which means its safe). Because of its molecular size, hyaluronic acid cannot penetrate the skin’s surface, and it is not systemically absorbed.


  • Benzoyl peroxide. Only 5% of topical benzoyl peroxide is absorbed through the skin. It is completely metabolized to benzoic acid within the skin and excreted.

Self-Tanners

Dihydroxyacetone is a color additive that is found in self-tanning products to produce an artificial tan. Color develops following topical application. These products contain dihydroxyacetone in concentrations ranging from 1% to 15%, and when applied topically, systemic levels are minimal (0.5%), and are considered safe to use.

Hair Removal and Bleaching Agents

  • Sodium, calcium, and potassium hydroxide, which are also found in depilatory creams, disassociate into sodium, calcium, potassium, and hydroxide ions, which are all present in the human body. Topical application of these products would not disrupt serum levels and would not be considered a problem for use during pregnancy.
  • Hydrogen peroxide. Hair-bleaching creams contain low concentrations of hydrogen peroxide, making it unlikely to be systemically absorbed. In addition, should it be absorbed, hydrogen peroxide is rapidly metabolized. Therefore, use of these products during pregnancy is not expected to be a concern when done in moderation.
  • Laser has some controversy as to whether or not it’s safe; again, there isn’t a lot of information. Lasers do not penetrate very deep and there is not chemical exchange into the body. One interesting thought from me, (not speaking from personal experience) the body becomes more sensitive during pregnancy, and some laser treatments hurt to begin with. I’m not sure I’d want to get laser under those circumstances!

Botox and Fillers

The safety of Botox injections during pregnancy is unknown (Class C), and while I wouldn’t recommend intentionally getting Botox injections during pregnancy, many women receive injections prior to being pregnant or when they do not know they are pregnant, and have not had any problems. Botox Cosmetic has never traveled systemically, and works only on the muscles into which it has been injected. Therefore, one could presume it is safe to undergo this procedure. But I still don’t recommend it.  Unless you’re planning on having a “Toddler and Tiara” baby.  Then it’s ok.

 

xoxo,

not pregnant LK


Image Salicylic Flash Peel followed by Glycolic/Retinol Peel

2 Sep

‘Tis the Season for Chemical Peels!  Yes! My skin was starting to break out from some life stress and my lackadaisical summer fun on the Cape was coming to a close (i.e. I will be out of prolonged sun exposure). My typical home-care regimen includes retinol and a skin lightener, which allows me to peel without prepping, so I was ready for my first peel of the season! I needed it too!

Pre-Peel Protocol

Prepping Your Skin for a Peel is very important.  At least 30 days prior to your peel you should not tan or burn your skin. And tanning or burning your skin should be a habit you avoid, in general. Also, it is advised that you discontinue use of any retinoids, retinols, glycolics, or AHA’s at least 48-72 hours before your chemical peel or any resurfacing treatment.

Customizing My Peel

The treatment I received was an Image Salicylic Peel followed by an Image Glycolic/Retinol Peel. The Salicylic Peel is designed for patients with acne, oily, or acne prone skin (me!). Salicylic Acid works to slow down the sebaceous gland, thus slowing oil production that clogs the pores. The Glycolic Acid gently exfoliates the dead skin cells, which in turn increases cellular turnover. In this case, we are also using the Salicylic Acid to dissolve the dead skin cells on the surface of my skin to therefore also allow the Glycolic/Retinol peel to penetrate my epidermis more evenly and allow for deeper penetration of the preceding peel, and therefore softer, smoother skin.

Anyone who has mature, dry, sensitive skin can have a peel, but some modifications would need to be made.

Step 1: Cleanse

My skin was cleansed with 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.



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

The degreasing solution is applied with gauze 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 the epidermis (that’s a fancy word for skin)!

Step 3: Salicylic Peel is Quickly Applied and Then Removed

(this technique is referred to as a “flash” peel)

It is important for a peel to penetrate the epidermis to have visible improvement in the condition of your skin.

The white spots on my face is called frosting. Achieving frosting is the goal with chemical peels. This is a reaction of the skin’s proteins with an acid in a low pH resulting in coagulation. The lower the pH, the more coagulation will result. The peel destroys the existing tissues in order for the body to heal and make new tissue.

Image Skincare’s chemical peels have a low pH (which means they are strong acids) and are therefore able to penetrate more deeply into the epidermis, and thus make more new tissues.


Step 4: Image Skincare Glycolic/Retinol I-Peel Applied and left on up to 5 minutes.

This peel from Image is in an Aloe Vera base, so this allows the peel to be massaged into the skin. The Image peels also contain other healing properties, besides aloe vera, like Vitamin C, skin lighteners, brighteners, antioxidants and peptides. So, the peels are actually healing your skin, as they peel it, giving you a healthier result, faster, because your skin is less traumatized by the peel!


Step 5: Peel is quickly removed with cool water.


This is what my skin looked like just after the peel was removed. You will notice my skin is a bit flushed or a little red, this is called erythema and is a normal, expected side effect from a peel. One of the amazing things that chemical peels do is stimulate blood flow and increase the rate of skin turnover, bringing newer cells to the surface more rapidly. This allows skin to begin to appear smoother, more hydrated, and more plump. Also, the increased blood flow brings more nutrients to the skin, therefore creating healthier skin!



Step 6: Ormedic Balancing Gel Masque


An ultra-gentle, organic cooling gel masque developed for compromised, inflamed or irritated skin. Organic Aloe Vera, Arnica Montana and licorice quickly help reduce redness and other signs of irritation while bringing sensitive skin into healthy balance. Also may used for highly reactive, rosacea or acneic skin types

Step 7: Vital C Hydrating Enzyme Masque


Gently exfoliates dead skin with enzymes and adds essential anti-oxidants and minerals to improve skin health.

After

This is what I looked like immediately after removing the masques, my skin is already less red and inflamed, and the healing and rejuvenating process has begun!

24 Hours Later
(no make-up)

The first 24 hours after having this peel your skin will feel tight and shedding may occur. The skin may appear darker, due to the exfoliation of dead skin cells that has melanin present. This will gently shed off.

Post-Peel Protocol

After this peel I used an Image Post Peel Kit, which contains the Ormedic Cleanser, Max Cream, Skin Balancing Serum, Ormedic Balancing Masque, and SPF. These products are used post peel because they are gentle, contain peptides needed to heal, melanocyte suppressants, and aloe for redness/irritation. It is especially important to use SPF and stay out of the sun post peel. Products containing retinol (only time I recommend NOT using retinol), glycolic acid, or alpha hydroxyl acid’s for about 5 days.

Xoxo, LK

***Guess what!!! I’m finally going under the knife and getting breast implants! You might think I don’t need it from my picture above, but I assure you… it’s all Victoria’s Secret! Of course, I’ll be blogging about my experience!


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

Prepping Your Skin for a Peel

28 Jun

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


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

Why Peel?

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

Prepping is important for several reasons.

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

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

Retinoic Acid

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

 

AHA’s

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

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


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

Bleaching Agents

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

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

Sunblock

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

So why is it important to establish a baseline?

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

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

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

“Youth No Longer Wasted On the Young”


Love LK.

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

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.

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!).

Botanical Ingredients in Skin Care Products

13 Feb
Ingredient Known Benefit    
Aloe vera Soothing, regenerative, moisturizing
Arnica (Arnica montana) Regenerative, soothing, antiseptic, stimulating
Calendula (Calendula officinalis) Regenerative, soothing, antiseptic
Camphor (Cinnamomum camphora) Anti-inflammatory, antiseptic, astringent, cooling, sedative
Carrot (Daucus carota) Purifying, regenerative
Cucumber (Cucumis sativus) Moisture-binding, soothing, softening, tightening, anti-inflammatory
Geranium (Pelargonium sp.) Strengthening (capillaries), smoothes, decongests
Hops (Humulus lupulus) Calming, restorative, estrogenic, antiseptic, emollient, astringent
Horsetail (Equisetum arvense) Anti-inflammatory, regenerative, strengthening, softening
Lemon (Citrus limonum) Antiseptic, purifying, lymphatic stimulant
Menthol (Mentha piperita) Antiseptic, analgesic, calming, cooling, circulation stimulant
Peppermint (Mentha piperita) Antiseptic, cooling, analgesic, calming
Rosemary (Rosmarinus officinalis) Regenerative, astringent, calming
Sage (Salvia officinalis) Antispasmodic, astringent, antiseptic, cooling
Spearmint (Mentha viridis) Anti-septic, cooling, analgesic
Tea tree (Melaleuca alternifolia) Antiseptic, germicidal, wound-healing, anti-inflammatory
Turmeric (Curcuma longa) Stimulating, regenerative, antiseptic, antioxidant, anti-inflammatory
Witch hazel (Hamamelis virginiana) Anti-inflammatory, wound-healing
Yucca (Yucca schidigera) Anti-inflammatory, soothing

I know there are some people out there who love anything that is “natural” (and they live in Cambridge) and love things such as “botanicals” (I don’t know why I put that in quotes… but it seems grammatically correct?).

Botanicals in Skin Care

Botanical extracts support the health, texture, and integrity of the skin, hair, and nails and are the largest category of pharmaceutical/cosmeceutical additives. (I guess people in Cambridge aren’t the only one’s who love natural products!)

All medicine (including the creams for your skin) come from either nature or are manmade in a lab (in Cambridge?). Penicillin comes from a mold derivative; Botox comes from a bacteria derivative, ect. Ect.

Nature provides us with plants that have very important functions in healthcare. Here’s a chart with some of those plants. (In other news… I found out I can type something in Microsoft and upload it directly to my blog! I’m so excited! My posts are about to be more visually pleasing!!! Charts and graphs and clip art and stuff!)

Product Review: Skin Cancer Preventing Ingredients

16 Nov
I hope I officially warned you about the dangers of tanning with my previous post.  I hope if you are regular tanner, you have considered switching to Spray tanning. Thank you for the great responses to that post!  I’m so proud of your efforts.  Did you see an Aesthetician yet?????  Because that’s Step 1: See a Professional.

Vitamin A

The “Skin Vitamin.”  An disposable  factor in the maintenance of youthful, healthy skin.  Helps prevent and reverse photo-aging and helps improve hydration.  The unique thing about the line Environ, is the Vitamin A is in graduated concentrations.  It is formulated in the form of Retinyl Palmitate and Acetate.  This allows you to treat your skin, while acclimating safely to the highest levels of vitamin A available topically. This process prevents the possibility of developing a retinoid reaction common to all high levels Vitamin A (don’t be scared… I LOVE rentinol for any skin that’s over 30 … or has been in a tanning bed).
Vitamin C
Vitamin C is a free radical scavenger and plays an important role in the formation of collagen.  Vitamin C combined with Vitamin A addresses skin laxity most effectively.  It also facilitates in the reduction of uneven skin tone and blemishes.  Oh, and it moisturizes like no other!
Antioxidants (Free Radical Quenchers)
Vitamins C, E, B5, beta-carotene are used to counteract the effects of the free radicals in the skin that are formed everyday.  Sounds important, because it truly is.  But  often times many of you  think:  I have NO idea what a free radical is or why I need an antioxidant.  This is my simple explanation:  Think about an atom.  It has electrons in the outer ring that can be knocked out of their orbit, making the atom unstable.  Also, there is now an electron flying around all over the place knocking other electrons out of orbit.  Not good.  I’ll explain why in a later post.  Too many electrons are bad, even in a blog post!
I obviously get inundated with questions about products.  I have two lines that I fully LOVE and in response to today’s post I recommend a line called Environ.(Can be purchased at Pure Skin Care Salon, in Stoughton MA).  This product was originally developed by Dr. Des Fernandes, a plastic surgeon who worked in reconstruction with cancer patients.  It is a pharmaceutical grade line and can and SHOULD only be bought from a trained professional.  I understand it is hard to switch your products, but please refer to my blog about why you should use cosmeceutical/pharmaceutical grade products, they really work!  This line has high doses of Vitamin A, C, & E Antioxidants, peptides, penetrant enhancers and much more.  All of the Ingredients are active, meaning the penetrate on a cellular level.  Many other lines only sit on the surface of the skin, and may feel good but do nothing.  LK Stamp of Approval.
I am so having one of my web designers create a stamp of approval icon!!!!! It’s the little things that excite me!!!   I hope they excite you and open you up to a new way of think.
 Skin Cancer is preventable and very curable if found early. 

Step 2: Spend wisely

13 Oct

If  you are going to take my advice to see an aesthetician, expect that you will leave with a few products as well.  But how will you know your making a good investment?

  • Expect to need 2 or 3 products.  No one needs 20 products in their medicine cabinet.  Learning how to use more than 2-3 products is overwhelming.  You should not feel this way!
  • The products should be either pharmaceutical or cosmeceutical grade (see definition below).
  • The product was explained to you.  The ingredients were explained to you.  Why you need it was explained to you.  (Can you tell I’m a fan of education yet?)
  • Although you might see change right away, it could take a few weeks to see the difference (skin cell turnover rate is about 3 weeks).
  • Skin care is a step program, and your products should treat the current state of your skin.

What’s wrong with your old products? 

Did you know anything you buy over the counter, whether it’s $7 at CVS or $350 at Chanel, is only FDA approved to work on the top layer of skin.  The top layer of skin is dead skin cells.  That’s why your moisturizer feels so good when you put it on, and 5 minutes later… meh

Math that Women Like:

Throw out the thousands of dollars of products that are just taking up cabinet space, and replace them with 3 or 4 that your aesthician recommends.

After about 2 weeks you can throw out another thousand dollars of make-up that doesn’t match your skin tone, gets cakey, and makes you look older.

True, a little pricey to start, but you just threw out $2,000 of products that are not doing anything for you.  It’s an investment, your face is worth it, and look how much money you’ll save on crap in the future!

Cosmeceuticals:  Definition: (noun) a hybrid word “Cosmetic” (smells pretty, feels nice) and “Pharmaceutical” (drug).  A group of skin care products that work in the dermal level of skin, where all the physiological processes take place.

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