Maxine,
The answer to your question regarding Fraxel laser use on the neck and chest is a definite yes. Fraxel laser is a fractionated laser. This means that rather than the treating the entire outer surface of the skin at one sitting the laser treats microscopically in a tiny dot-like fashion, which leaves untreated skin, at a microscopic level, between the laser treated skin areas. This allows for much quicker healing and also allows the procedure to be safely performed on areas of the body which did not have the same characteristics as the face. Ablative therapies such as chemical peel and laser which can be used on the face cannot be used safely on the neck and chest. Fraxel laser however definitely can. We would be happy to see you in consultation to provide you with more specific information to your concerns. There is also additional information on our site regarding Fraxel laser as well as other treatment options.
Ed Buckingham
Christina,
Dermabrasion and microdermabrasion are very different. Microdermabrasion is a procedure utilizing crystals to remove the dead skin cells from the outer surface of the face. It will only allow your face to feel smoother but will not stimulate collagen production or improve wrinkling. Dermabrasion is a procedure utilizing either a diamond sanding wheel or a wire brush to remove the outer epidermis and dermis of the skin which is much deeper than micro-dermabrasion and allows for improvement in wrinkles and collagen production. We usually utilize a trichloracetic acid chemical peel for the wrinkles on the entire face, which also improves pigment, and allows for collagen regeneration. We combine this with dermabrasion for the perioral area in patients with a deep perioral lines. The dermabrasion does require a significant downtime and there is a small risk of pigmentation loss and scarring. It does offer the best chance for the most significant improvement however. We have examples of both chemical peels and dermabrasion on the site and I encourage you to explore our photo Gallery. Thank you for your question; we would be happy to see you anytime.
Ed Buckingham
Constance,
Wow! That was a long and very good question regarding hyaluronic acid fillers, Restylane, Perlane and Juvederm. You are right to be confused because of all the different fillers. It is only going to get worse. The fillers do have differences microscopically regarding how they are processed, how much crosslinking there is between molecules and how much of the actual hyaluronic acid is present. Clinically there is a little difference in the feel of the product as it injects and some people feel there is a difference in how the product feels in the face as well. Regarding that Restylane tends to have a little more body than Juvederm which in my opinion is better for folds. Juvederm tends to feel a little softer, which is why some people prefer it for lip injections. In general though good results can be achieved with either product. Regarding Restylane vs Perlane. Perlane has more cross-llinking and is therefore thicker, just like the difference between Juvederm ultra and ulta plus. The thicker products are better for deeper folds and the thinner products for lips and fine lines. Selecting which product to use is done at the consultation and varies between patients. Regarding the Juvederm commercial, looking overdone is a product of technique and quantity. I believe that our patients achieve very natural results. Please feel free to look at our photo gallery and decide for yourself. We look forward to seeing you.
Ed Buckingham
Camile,
Thanks for your questions regarding Relaxed Expressions and Botox. Regarding longevity, Botox lasts 3-4 months reliably. Relaxed Expressions is harder to quantify. Firstly, Botox completely relaxes the muscles, Relaxed Expressions completely relaxes the muscles initially through ablating the nerves to the muscle, but over time (6-12 months) there is a varying recovery in the nerve. Some patients get just enough recovery to produce some expression without causing a deep furrow when they scowl. This is a perfect result and exactly what the procedure was intended to do. In my opinion patients with this level of recovery at one year will maintain that result forever, although we don’t know that for sure as we haven’t followed any patients forever. The limitation of the procedure is that some patients will get more recovery than desired and will need to be re-treated. As far as choosing Relaxed Expressions over Botox, it is individual. When you come in for a consultation we will examine your lines of expression and determine whether the procedure is appropriate for you. We can then go over the entire procedure and you can decide based upon all the information. There is some down-time from Relaxed Expressions. There is about a week of swelling in the brow area and sometimes some bruising as well. Relaxed expressions is only for treating the frown lines. If a patient already has furrows then a filler will have to be added to complete the result.
I hope this helps. We would be happy to talk with you further if you like.
Ed Buckingham
T,
It is certainly possible that your friend did have a result from Thermage. It could also be possible that the result is from the addition of good skin care; hard to tell which. The problem I have seen in the Thermage results is that in some patients there is a real difference and in others there is not any. I have been told that even in patients who get a result, they do not last, but again I do not have any personal experience with the procedure. The healing process only lasts about 3 months, in my opinion, so I wouldn’t expect the results to get any better after that amount of time. As for whether the price was worth it only she can answer that question. If she has seen a real result and is happy with the improvement then I would say she received a fair value. I prefer to utilize procedures that produce reliable results in every patient. Therefore I do not offer Thermage.
Ed Buckingham
