Q: Chemical Peel for Face: Tips for Choosing the Right One
I have trouble understanding all the names and concentrations for chemical facial peel. TCA, AHA peels, Jessner peel, Obagi, etc. How do you know what's best for the face?
A: Choosing the best chemical peel
The best way to know which chemical peel type is best for you is to have a consultation with the doctor as he/she will know which specific type of chemical peel is right for you. There are light, medium, and heavy chemical peels, and several listed under each of them. In general, light peels cause little or know "down time" and several are needed for the best effects. Medium peels have significantly more "dome" (needed to recover) and more pronounced peeling, but ultimately more skin improvement. Heavy peels often take 2 week or longer to recover, cost significantly more, but produce the most noticeable change and incredible improvement. For first timers, trying a test area out usually is a good idea.
Learn more about chemical peels by clicking here.
Q: Can Juvederm Add Volume to Sunken Cheeks?
Can Juvederm be used to add volume to the sides of the face that have flattened out due to aging?
A: Juvederm is great for adding volume back to the face
One of the other "new" ways to use Juvederm is to add volume to the sides of the face that have flattened out due to aging. We lose more volume from our faces every five to ten years and fillers are the perfect way to improve that look.
Q: Juvederm Swelling
I had my lips injected today with Juvederm and am wondering if appearance is due to swelling. My lower lip in the corner area on one side is fuller than the other side. I don't know if this could be just swelling or if perhaps I was injected with too much too far into the corner. My question is within 8 hrs after injections would I have a good picture of evenness of my lips or due to swelling is it hard to tell.
A: Juvederm swelling can last up to 3 days
Lips are an interesting area to inject with fillers like Juvederm- I am a big proponent of "less is more", namely, that you want to undershoot the amount used to fill the lip and adjacent areas. After a lip treatment, I always take time to feel the lips for evenness and with gloved hand and gently smooth away any irregularities. I also remind patients that some people get almost no swelling while others swell a lot for 2-3 days! After about 5 days, I tell them to come in for a quick look and see if any adjustments need to be done.
Q: Restylane and Juvederm Bumps - What Causes Them?
I have read many people complain of bumps after having Restylane or Juvaderm injections and others who love them. Are the bumps caused by user error or is that a possible side effect? I am researching having wrinkle fillers. Although I am realistic and know I won't have the face I did 30 years ago, I also can't see doing this and finding my wrinkles less noticeable, but that the bumps have taken their place. Also, about how many cc's does it take on the average person to do around the nose, mouth and upper lip area?
A: Bumps from filler injections are uncommon
When properly injected, Juvederm or Restylane should not result in bumps. Once in a while, a bump can form, but it is always temporary. There is a medicine that can be injected into the bump to dissolve it. In my experience, bumps with these injections are uncommon because we use an advanced injection technique that minimizes this possibility.
Learn more about dermal fillers Restylane and Juvederm by clicking here.
Q: Laser Tattoo Removal Scar
When getting the laser removal for tattoos, does it leave a scar and will it get rid of the tattoo completely?
A: Alexandrite laser is great for tattoo removal
We mostly use the Alexandrite ("Alex") laser for tattoo removal. This laser does an excellent job of removing most dark green ink used in tattoos. Most patients do not experience permanent pigment changes or scarring, however patients with darker skin types do have a higher chance of darkening or even lightening with tattoo removal. If your tattoo is very densely pigmented or has multiple colors then more treatments will be needed (sometimes up to 10) and the tattoo may never be 100% removed. In these cases, some patients will opt to tattoo over the old tattoo once we have removed all the pigment possible.
Learn more about laser tattoo removal by clicking here.
Q: Fraxel Repair Recovery and Healing
How long does Fraxel repair recovery usually last? Can you break down the recovery time for me, like how long until you can be seen in public, wear makeup, look completely normal etc.
A: Fraxel recovery time depends on treatment strength
Fraxel recovery can take as little as 3 to 4 days (for a lighter treatment) and up to 10 days (for a deep treatment). The type of treatment you will need depends on the amount of sun damage and wrinkling we are trying to repair. The recovery is not painful however the skin is pink to red and peels on the second or third day. Most patients are able to return to work by the 4th or 5th day after treatment. Although the skin can remain pink for 1 to 3 weeks (depending again on the depth of your treatment), but it is ok to wear makeup to cover up the redness.
Q: Can Fraxel Be Used on Dark or Hispanic Skin Types?
Can this laser be used on a dark skinned person? I'm 23, Latino male, with some hyperpigmentation and some depressed scars. I have been looking for some kind of treatment but most doctors won't recommend much since my skin has a dark tone.
A: Fraxel laser is not good for dark skin tones, but fillers are a good option
Unfortunately, the advice you received is correct. People with darker skin tones (darker Caucasians tones, Latinos, Asians and African Americans) are not good candidates for aggressive laser procedures that are necessary to treat deep acne scarring. Furthermore, less aggressive treatments, such as light chemical peels and microdermabrasion, are ineffective at treating acne scars.
However, the newer fillers, such as Restylane and Juvederm, are effective at filling in and smoothing many acne scars in darker skinned patients. Yes, this is temporary and has to be "touched up" about once a year, but it is still a good option for darker skinned patients who are not good candidates for the laser.
Learn more about fractional CO2 resurfacing with the Fraxel Repair by clicking here.
Q: Will V Beam Help with Acne?
I want to go get V Beam treatments for my redness. I also have some acne that is stubborn. I have heard that V Beam can help acne too. If I get the V Beam for the redness, will it also help my acne? Or do they use it differently for redness than they do for acne? Thanks.
A: VBeam will help acne
Yes. The VBeam can be used as part of a procedure called photodynamic therapy or PDT. In this procedure, a chemical solution is applied to the skin and after a waiting period of a few minutes, the VBeam laser is used to activate the solution. The effect of this is to kill the bacteria that cause acne, resulting in an improvement in complexion.
Q: Can the VBeam Improve Skin Texture?
Is the VBeam laser treatment good for improving skin texture?
A: VBeam will not improve skin texture much, works best for treating redness
The VBeam will not improve your skin texture that much. The VBeam is best for treating redness from rosacea and broken capillaries on the face. It also works well for:
Learn more about Vbeam laser treatments by clicking here.
Q: How Much Does Hair Transplant Cost?
Hard to figure out what I should pay for a hair transplant procedure. Price ranges would be helpful at this stage.
A: Prices vary depending on number of grafts
At my practice cost can vary from patient to patient, depending on the number of grafts needed. During the consultation process we will determine how many grafts you need and what price your particular needs will cost. It is important to be wary of physicians offering huge discounts on hair transplants because you do not want to lose the quality treatment that an experienced doctor provides (at a higher price).
Q: How Does a Hair Transplant Work?
I assume hair transplant surgery is indeed that, surgery. But what are the steps that you go through during hair transplantation?
A: Hair transplant procedure
All of these steps will be explained to you during your consultation most of which should be done with the surgeon doing most of the consultation (although in many large hair transplant "offices", the consultation is done only by the staff and the patient doesn't meet the surgeon until the day of the procedure).
After the area of the scalp skin that is going to be worked on is anesthetized, these are in the back of the scalp, a small narrow strip is removed and they are cut into small 1 or 2 hair grafts. The surgical donor area is then closed. The patient is then turned on his back. The bald skin in the front of the scalp is anesthetized and tiny holes made by a toothpick are made and then the 1 or 2 hair grafts are placed as close as possible in the previously bald scalp. A light dressing is applied which will be taken off the next day. And then in about 6-9 months brand new hairs are seen growing out all over the previously bald scalp.
Q: How to Stop Hair from Shedding?
My hair has been shedding like crazy lately. It doesn't matter whether I comb or just touch it. It looks and feels thinner but I don't see any patches.
It has been shedding for over a year now but never this bad. I have also noticed little broken bits recently but this is nowhere near as bad as the shedding. Can you please advise?
A: Seek consultation with a hair loss expert
Losing hair and shedding heavily for more than 6-12 months is the perfect time to have a hair loss consultation with an expert who will take a detailed history of you, a family history, medical and medication history. Then he will examine your hair and scalp and note any abnormalities, laboratory tests will be done, and photographs of you will be taken. After these results are analyzed, you will be given a diagnosis and a treatment plan to help start improvement on your own.
Q: What Type of Doctor Should I See for Thinning Hair?
I am a 53 year old woman and my hair has lost its body and is thinning. Who should I see? Can a dermatologist help me?
A: Start with a dermatologist, but find a hair loss specialist
In general, seeking the advise of a dermatologist is a good place to start. However, many dermatologists are not prepared or really interested in hair loss. In general, avoid those large hair transplant clinics, for 2 reasons:
Another source to find a medical hair loss expert is to call your local medical school and ask for the Dermatology Department. They will be able to recommend a doctor at the medical school or one in your city who is a respected hair loss doctor.
Q: How Can I Slow Down the Balding Process?
My son's head hair is thinning at an alarming rate, he is 20 years old, there is no history of baldness on either side of the familly other than an uncle on his mother's side. Any ides of how to stop this or what he can do?
A: Seek consultation with a hair loss expert
A young man of 20 with obvious thinning hair should have a consultation with a hair expert. Call your local dermatologist and check to see who is considered the " Hair Loss Expert" for medical treatment.
In general, be cautious and probably avoid "Hair Transplant Clinics," as they are there to aggressively sell you on micrograft hair transplants. Most 20 year old guys losing hair need to first figure out what to do to slow down the accelerated hair loss they are already experiencing. There is a variety of good medical treatments out there that are FDA approved for male pattern hair loss.
After maximal medical control of advancing hair loss is obtained, then the patient in his 20's, or whatever age, can seek information on the pros and cons of surgical hair restoration, possibly from the physcian they are already seeing for medical hair loss treatment.
Q: Can a Laser Stimulate Hair Growth?
I have had laser hair removal with Lumenis Lightsheer for 6 sessions. I am not seeing any improvement after the 4th session. Actually, on the 4th session, when the doctor increased the setting, I noticed hair grow back more and darker. Should I continue the treatment? Or I should switch to another Laser or clinic?
A: Hair removal takes time
First of all, I truly doubt that any laser used for hair removal could cause more hair re-growth, especially if a very good laser like the Lumenis Lightsheer is used. Patients are sometimes unclear that even with lasers, hair removal takes many sessions and a fair bit of time to see improvement. However, compared to old-fashioned electrolysis, it is more than 100 times faster.
Before switching to another physician or other laser treatment center, I would speak to the doctor and ask him a few questions:
I have a patient, who is not seeing me for his hair removal, who told me that he decided to get electrolysis to remove his fairly densely hairy back. He went every week for an hour over a 2 year period until it was declared that he was finished- that is over 100 electrolysis treatments.
You just need to be patient and understand that hair removal is a process, but eventually you will get the results you are looking for.
Q: Hair Transplant or Topical Treatment?
My mom is 45 years old and has a dreadfully thin crown area. Does she need a transplant or should she try to work with a dermatologist for a more topical treatment?
A: Multiple treatment options for thinning hair
Several FDA approved medications are available for the treatment of patterned hair loss in men and in women. These included OTC products like minoxidil 2-5%, oral medication such as finastseride (Propecia), as well as several new ones under development. Once hair loss acceleration is controlled, evaluation for surgical hair replacement can begin.
Remember to consult a medical hair loss expert and he or another physician may also be able to evaluate the patient for micro-graft surgical hair restoration.
Learn more about hair loss by clicking here.
Learn more about hair restoration treatments by clicking here.
Q: Mohs Surgery on Nose - Stitches or Left to Heal by Itself?
I had a biopsy and the results are that I have a squamous cell on the tip on my nose, very small area. Using a Mohs Surgeon how will he/she determine if the procedure will be conducted with stitches or left to heal by itself. Please advise.
A: The need for stitches depends on the size of the cancer
If the cancer is small and is removed with the first layer (stage) of the Mohs procedure then there is a good chance we can let the body heal naturally and stitches will not be needed. However, if the cancer is larger, and the defect is wider or deeper after the cancer is removed, then a repair with stitches is often recommended for the best cosmetic results.
Learn more about skin cancer and MOHS surgery by clicking here.
Q: What Are the Best Botox Alternatives?
Not so sure I want to try Botox. Are there good alternatives that will help me get rid of wrinkles on my forehead the same way Botox does?
A: Dysport is a Botox alternative
This year a new rival solution was introduced to compete with Botox and is called Dysport. They work very similarly and both begin to show effect within the similar time frames from when they are injected and when they begin to work. Otherwise, there are no other Botox alternatives. No other surgical, laser, or injectable can accomplish what Botox (and Dysport) do.
Q: Can Botox Injections Be Reversed?
If you have had too much Botox in an area is there an antidote to help release the effects quicker?
A: Botox can't be reversed
The effects of Botox injections cannot be reversed as far as anyone knows. The only area that can be treated is if some Botox gets too low or deeply behind the can thus and forehead muscles and gets into the area behind the eye, which can result in mild upper lid weakness or drooping. A prescription eye medication can help strengthen the weakened eye muscle, but it must be used daily until the Botox solution has metabolized away.
Q: Dysport Side Effects - What Are Common Complications?
I am trying to decide on Dysport for wrinkles in my forehead area, but worried the drug is so new that the side effects of Dysport are yet to be fully discovered. Can the doctors share what are the side effects they are seeing with Dysport so I can be better informed?
A: Dysport is very similar to Botox and has no hidden side effects
Dysport is only new to the US. Dysport has been widely used in Europe for years and has a safety record that is similar to Botox. The two medications are quite similar with only minor differences in their onset and duration of action. Also, Dysport tends to spread out a little more than Botox but we can easily compensate for this by placing the injection points a little differently than with Botox.
Learn more about Botox by clicking here.
Q: How Can Large Veins Under the Eyes Be Treated?
I am 58 & with thin skin, I look like an owl because I have large veins under my eyes. I have heard that there is a laser that can get rid of veins (or at least diminish the size). Is there such a laser that can reduce veins in the face?
A: Fillers are a better option than lasers to reduce under eye veins
Large veins under the eye are an annoying look that many people would like to correct. However, the problem is difficult. Traditional methods of making large veins disappear are often more risky that they first appear- with both sclerotherapy (injection of solution in unwanted leg veins) and with lasers, there is a small but real risk that large veins could send a small clot or embolus to the retinal veins and cause serious eye problems. Although this is a rare side effect, it deters most physicians from offering this type of treatment for large veins under the eyes. Another approach that is safer is the use of filler injections, like Restylane, to act as an in between layer between the vein and the areas of lost volume in the "tear trough area" which can help obscure the bluish color and fill in the volume in these sunken in type areas. For other areas on the face, there are several very good vascular lasers that can be used away from the eyes to reduce red vessels (arterioles) and purple vessels (venules). Some of the better lasers for vessels on the face include the Versapulse and the V Beam laser.
Q: Does Sclerotherapy Work?
I'm 30 years old and plan to get sclerotherapy. Does it work and what are the side effects? How much does it cost?
A: Sclerotherapy works very well
Sclerotherapy for treatment of unwanted vessels on the thighs and legs works very well and most patients are extremely pleased with their results. Side effects of treatment include:
Cost per procedure is variable in different parts of the country, but based on the amount of areas treated (or the volume of sclerosant used) , the cost can run $250- $500 per session with most patients needing 2-4 treatments for minor vessels and 8 or more session for more major vessels.
Q: How Soon Should I See Results After Sclerotherapy?
I would like to know how fast will I see results after the Sclerotherapy procedure and after laser treatment? Which among the two is more effective?
A: Sclerotherapy is the better treatment
Improvement from sclerotherapy may be as soon as 1-2 months after treatment, but it may take longer even up to 6 months or more. Most experts in treatment of varicose venuels, spider veins and other unwanted thigh and leg vessels generally agree that sclerotherapy (injection of the veins with a solution that causes the vessel walls to be become irritated and ultimately stick together not allowing blood to pass through them) is the superior technique.
They agree that laser treatment of vessels works better with facial vessels of all sorts.
Learn more about vein therapy and sclerotherapy by clicking here.