Skin Rejuvenation

Fotofacial

Who is a candidate for FotoFacial?

  • People who suffer from rosacea and experience flushing and redness.
  • People with early aging changes and sun damage.
  • People who don't want the downtime of laser resurfacing.

How does it work?
Skin Treatments often consist of full-face or body treatments, using gentle energy parameters. The treatment regime typically consists of:

Four to six treatments administered to the whole face, chest, neck or hands, spaced at three week intervals

Broad spectrum light in the visible and near infrared range, from 515 nm up to about 1200 nm

Light is transmitted through a small, smooth, flat glass hand piece which is gently placed over the skin

What results can I expect?
You can expect to see a gradual decrease in overall redness, flushing and dilated capillaries.

Sun damaged skin will become smoother with a decrease in fine wrinkles, reduction in pore size, and fading of sun spots.

Many people with rosacea see an improvement in breakouts and are able to decrease or discontinue their medications.

How soon will I see results?
After your first Fotofaical treatment, your skin will feel smoother and will have a more even tone. These improvements are gradual and will be more visible after each treatment. Five treatments are performed for optimal results. some patients benefit from additional treatments.

Who "discovered" this technique?
Dr. Bitter (a dermatologist in California) first published this technique and has been doing it since 1998. Dr. Mullholland (a plastic surgeon in Toronto) also helped refine the procedure especially with regards to wrinkle improvement. Dr. Speron has been performing this procedure since July 2000 and has taken extensive additional training courses by Drs. Bitter and Mullholland (as have the nurses performing this procedure in our office).

What areas can be treated?
There are many skin rejuvenation devices on the market today for treating areas other than just the face. The neck, chest, back and extremities may also be treated. Please consult with your physician regarding your specific requirements.

Who are candidates for treatment?
Nearly every patient type. Leading physicians worldwide report excellent results on patients of virtually all skin colors, most complexion types and nearly any age.

What is treatment like?
Patients experience minimal discomfort. We routinely give patients LMX (a topical anesthetic) so that they may be comfortable during the procedure. Some patients do not need it.

How long is a typical treatment?
Each case varies. When only small areas are treated, the procedure time is short. Typically the procedure may last up to an hour.

What are the side effects?
Side effects vary individually, but they are typically minimal. The risk of burns from the laser are < 1%.

Are there restrictions on my activity after treatment?
Following treatment, there should be only minimal restrictions on your activities. Most patients return to work or social activities right away. You can start exercising the next day. Make up can be worn immediately.

Fotolift

Fotolift is one of the newest laser treatments available today. According to physicians, Fotolift is the best nonsurgical facelift or skin tightening "no downtime" laser treatment modalities on the market.

There are a wide variety of medical lasers and light systems now available to rejuvenate the skin. Some lasers, however, are not effective for certain skin types. With the FotoLift, however, all patients (regardless of skin type) who wish to rejuvenate their skin can have this treatment. The Fotolift can benefit many different types of people with many different types of ethnic backgrounds. The FotoLift Polaris is state of the art treatment for skin tightening and wrinkle reduction. The innovative Fotolift treatment is most commonly used for the facial and neck non-ablative (not shedding skin) rejuvenation. Because you are not shedding any skin, unlike laser resurfacing, you can have treatment with Polaris and be back at work the same day. The energy is focused beneath the skin surface which minimizes the risk of visible skin injury. Thus, it is considered a (no downtime) non-ablative laser treatment. The Syneron Fotolift device was named the best anti-aging treatment of 2004 by New York Magazine!

FotoLift treatment sessions are usually not painful, and do not require local anesthetic. Most physicians, however, do recommend using topical anesthetic cream. Most physicians recommend five treatments. You will begin to see results in the mirror after 3 sessions, with each treatment having a higher energy level to increasingly stimulate collagen growth.

From a medical point of view, Polaris is actually a combination of a 900nm Diode laser and bipolar radiofrequency (ELOS). This requires overall lower energy levels for superior results with maximum safety and comfort. The heating of the Polaris produces results at both the epidermal and deep dermal levels. Energy is sent precisely and effectively to the treatment zone. Light (laser energy) creates higher temperatures in the epidermis, treating fine wrinkles at the surface, while the combination of light and RF penetrates deep into the dermis to treat deeper wrinkles.

Remember, it generally takes up to five treatments to achieve the maximum effect. FotoLift creates skin tightening and wrinkle reduction through stimulation and production of your own body’s collagen. The full benefits of treatment can take 6-12 months to become apparent. The new collagen that is formed is permanent, unlike injected collagen, but is subject to natural deterioration with continued aging. Maintenance treatments are usually recommended every 6 - 12 months.

Even though Polaris Fotolift treatments are mainly used for the face and neck, they are not limited to these areas. FotoBody can be used for problem areas on other parts of the body, like sun damaged or aging skin of the chest, hands, legs and forearms. The FotoFacial (and FotoBody) treats age spots, freckles, and other pigmented blemishes and helps restore youthful glow, radiance and smoothness to the complexion. The FotoLift firms, tones and tightens the skin -- this can be used on many areas of your body.

PhotoDynamic Therapy and Amino-Levulinic Acid

PhotoDynamic Therapy has become the most effective way for treating acne conditions. Lasers help shrink the Sebaceous glands (oil-producing glands) and reduce sebum production in a few treatments. This new therapy is becoming the latest in combination techniques working to kill bacteria and shrink sebaceous glands. These lasers are known to also improve collagen formation and the appearance of acne scars.

The ELOS acne laser therapy is a non-ablative laser, using a broad spectrum of Light and Radio Frequency energies to target the sebaceous glands. The light frequency heats up the P.Acnes (acne bacteria in the pores) and helps shrink the sebaceous glands. Radio frequency helps to improve the texture of skin, which most acne patients suffer from rough, oily and blotchy skin. This treatment has no down time, low risk and offers a safe improvement for those with active acne.

What is Amino-Levulinic Acid (ALA)?
Amino-Levulinic Acid or ALA is a naturally occurring substance in the body. This product is applied topically and the body selectively absorbs the substance into the sebaceous glands, hair follicles and photo-damaged skin cells. The ALA is converted into a photosensitizer and activated by light treatment, which then destroys the targeted cells in the skin. ALA is left on the skin for 30 to 60 minutes before activated with the PhotoDynamic Therapy. This product is activated by light sources. Patients must remain out of the sun or bright indoor light for a minimum of 48 hours post treatment. Sunscreens do not protect against photosensitivity in the skin.

How is the Amino-Levulinic Acid (ALA) Activated?
This treatment is a two-step process which the product is applied and then the ALA is activated. First, the ALA will be applied to the skin. The ALA becomes a photosensitizer and the acne lesions are attracted to the solution. The ALA will remain on the skin for 30 to 60 minutes. After the product has settled into the skin we will perform the Acne Laser treatment on the skin, which activates the photosensitizer. The purpose of this treatment is to stimulate a photochemical reaction in the skin. A significant improvement in moderate to severe acne can be achieved in as little as one to three treatments.

What are the risks involved?
ALA is a safe alternative to antibiotics and chemical acne treatments. Most patients feel no discomfort, but some experience mild discomfort, such as stinging, burning, and tingling of the acne lesions. Change in skin color may occur and skin may turn red and have mild swelling the following week. Slight scabbing may occur on the acne lesions. Skin becomes very sensitive to any light source, such as sun and bright indoor lighting. The skin slowly heals and begins to show gradual improvement throughout the series of treatments.

What else does Amino-Levulinic Acid (ALA) treat?
Besides treatment of acne lesions, ALA can help with other skin conditions as well:

  • Precancerous skin lesions by preventing skin cancer
  • Improvement of wrinkles and pore size
  • Improvement of skin texture
  • Minimizing pigmentation
  • Treatment of sebaceous hyperplasia

Laser Skin Resurfacing

Aging, sun exposure, heredity and lifestyle factors including nutrition, alcohol consumption and smoking all may contribute to facial wrinkling.

Pigmentary changes of the skin, such as blotchiness or brown spots, may also occur with age or as a result of birth control pills, pregnancy or genetic factors. Prior acne may have made the surface of your skin uneven. These problems, as well as certain other skin conditions, may be improved by laser skin resurfacing.

Am I a good candidate for skin resurfacing?
You may be a good candidate for skin resurfacing if you have one or more of the following conditions:

  • Wrinkled or sun-damaged facial skin
  • Vertical wrinkles around your mouth, such as those that cause lipstick "bleed"
  • Crow's feet lines around your eyes and perhaps some skin laxity in your lower eyelid area
  • Fine wrinkling of your upper eyelids
  • Brown spots or blotchy skin coloring
  • Certain precancerous skin growths
  • Acne or chicken pox scars
  • Superficial facial scars from a past injury

Patients may have their skin resurfaced at almost any age. You may have certain characteristics that make you a better candidate for one technique rather than another, or your surgeon may have a preference based on his or her personal experience with the different methods.

The amount of time you can allow for recovery also may be an important factor in selecting a particular resurfacing method or determining the extent of treatment. All skin resurfacing techniques can be performed to varying depths.

A more superficial treatment will require less healing time, but you may need to have the procedure repeated more than once to achieve the same results as a deeper treatment. If you are having aesthetic (cosmetic) surgery, such as a facelift or eyelid surgery, you may be able to have a skin resurfacing procedure performed at the same time.

Skin Resurfacing Techniques

Chemical peels, dermabrasion and laser skin resurfacing all achieve results in basically the same way. Layers of your skin are removed and, as the healing process progresses, a new, healthier-looking skin emerges. What differentiates the various resurfacing methods is the way in which the skin's layers are removed. Chemical peels involve the application of a caustic solution, dermabrasion utilizes high-speed rotary wheel, and laser resurfacing uses a laser beam.

How is a chemical peel performed?
A chemical peel solution may be applied to your entire face or just to certain regions, such as the crow's feet area around your eyes or the vertical wrinkles around your mouth. Your plastic surgeon will apply the solution using a sponge, a cotton pad or sometimes, for smaller areas, a cotton swab or brush. Your surgeon decides how long to leave the solution on your face by carefully observing any changes in the appearance of your skin. With certain types of chemical peels, the solution may be "neutralized" after an appropriate amount of time has elapsed.

What are the different types of chemical peels?
The different types of chemical peels vary according to their specific ingredients and their strength. The depth of their peeling action may also be determined by factors such as how long they remain on the skin and whether they are applied lightly or rubbed more vigorously onto the skin.

AlphaHydroxy Acids (AHAs): Glycolic Acid is the most superficial peel, up to 30%. Sometimes just a single treatment with an AHA peel will give your skin a fresher, healthier appearance and radiant glow. Repeated treatments can help to further improve the texture of your skin. AHA peels can reduce the effects of aging and sun damage including fine wrinkling and brown spots. Your surgeon will recommend a maintenance program using AHA products that you apply at home on a regular basis.

An AHA peel is performed in your plastic surgeon's office. No anesthesia or sedation is needed, and you will only feel a tingling or mild stinging sensation when the solution is applied to your face. Immediately after the procedure, you generally will be able to wear makeup, and you can drive yourself home or back to work.

A trichloracetic acid (TCA) peel is often used for the treatment of wrinkles, pigmentary changes and skin blemishes. Many patients can benefit from having TCA applied not only on the face but also on the neck and other parts of the body that have been exposed to the sun. For spot peeling of limited areas such as around the mouth or eyes, TCA formulas are often preferred because they have less bleaching effect than solutions containing phenol, another popular peeling agent. For the same reason, some surgeons have found TCA to be effective in treating darker-skinned patients. Milder TCA peels can be repeated frequently in order to achieve cumulative effects, or TCA can be used to achieve a medium or even a deep peel, depending on the acid concentration and manner of application.

BetaHydroxy Acids (BHAs): Salicylic Acid, the most popular BHA, works mainly as an exfoliant. It causes cells of the epidermis to become "unglued," allowing the dead skin cells to slough off, making room for new skin growth. Salicylic Acid is reported to improve wrinkling, roughness and mottled pigmentation of photo damaged skin.

A salicylic acid solution can work in a way that is similar to a glycolic acid peel, but irritation may be reduced. A deep BHA peel can be superior for many skin types because the irritation and inflammation are kept to a minimum due to the analgesic action of the BHA compound. Salicylic acid is also lipid soluble; therefore, it is a good peeling agent for blemish-prone skin with blackheads. The most common concentrations used today are 20% to 30%.

Phenol peels: These peels are sometimes recommended for treating particularly rough and sun-damaged facial skin. Phenol is effective in reducing the appearance of wrinkles ranging from fine lines to deeper creases. It can correct pigmentary problems including blotchiness or age-related brown spots and may be used in the treatment of precancerous skin conditions.

Phenol is particularly useful for minimizing the vertical lines that often form around the mouth as a result of aging. The disadvantage of phenol for spot peeling of limited areas is that it often has a significant bleaching effect. After your skin has been treated with phenol, you may need to wear makeup in order for the treated portions of your skin to more closely match the skin color of the surrounding areas. Unlike TCA peels, phenol cannot be used on your neck or other parts of your body.

Certain variations in the phenol peel formula, creating a "buffered" or milder solution, may allow for greater flexibility in its use.

How is dermabrasion performed?
Dermabrasion uses a small, rapidly spinning wheel with a roughened surface similar to fine-grained sandpaper to abrade the skin, removing its upper layers. This resurfacing procedure sometimes is selected for the treatment of facial scars such as those caused by acne and often is performed on the cheeks or the entire face.

Dermabrasion, like the deeper chemical peels, is very effective in reducing the appearance of vertical wrinkles around the mouth that often cause lipstick "bleed". It can be used on a small area of skin and on patients with somewhat darker complexions. The treated area usually will blend with the surrounding skin so that there is little if any noticeable difference in the pigmentation.

How is laser resurfacing performed?
Skin resurfacing using a carbon dioxide (CO2) laser is the most recently developed of the techniques described in this brochure. Its effects are similar to those of chemical peels and dermabrasion, except that the laser removes skin layers by vaporization rather than with chemicals or a sanding device. Your plastic surgeon is trained in the safe use of laser equipment. He or she is able to specify the amount of energy transmitted to the skin's surface by the laser beam and control the depth of penetration.

Like the other resurfacing methods, the laser is effective in treating wrinkles, blotchiness or age spots, and scars from acne or other causes. It can be used on the entire face or specific areas. Patients with a variety complexions, including some darker-skinned individuals, may be treated with the laser. Certain other characteristics of your skin, such as its thickness and texture, may influence whether you are a good candidate for laser resurfacing. Some patients may benefit from the laser's mild "tightening" effect on the skin, particularly in the lower eyelid area where the skin often becomes somewhat loose as a result of aging.



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