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Category: Cosmetic Procedures

Kybella Injections for Chin Fat: What You Need to Know

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  1. What is Kybella?

KYBELLA™ (deoxycholic acid) is the first, and currently the only FDA-approved non-invasive treatment that helps contour and eliminate the double-chin area by disrupting the fat cells that collect under the chin.

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  1. Does it hurt?

This treatment is safe and effective.  Kybella is administered through very tiny needle injections (same size as botox injections).  There may be some burning sensation that occurs for about 10-15minutes after injection. This does subside, but like with any injectable there are common side effects such as swelling, bruising, redness, numbness, and slight pain.

 

  1. How many sessions does it take to see results?

The amount of sessions for treatment depends on the amount of fat that is in the area that is to be treated. Most patients will require a minimum of 3 treatments and a patient with a larger treatment are will require anywhere between 4-5 treatment sessions spaced 6-8 weeks apart.

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  1. Who’s a good candidate?

People who feel their jawline and neck area is saggy as a result of under chin fat, or those who see a double chin on front view or profile.  This is a great procedure for patients that have the desire to have that area of the double chin fat eliminated without surgery or liposuction.  Ideal patients are of normal body weight and not had surgery to the area.

 

  1. Is there any downtime?

There is about 3-5 days of redness and swelling.  Some patients may consider having the treatment on Thursday or Friday to be optimized for going back to work on Monday.

 

  1. Where does the fat go?

When Kybella is injected into the fat beneath the chin it eliminates the fat cells in that area. Once those cells have been destroyed they cannot store or accumulate fat and they are processed through your body’s metabolic system.

 

  1. Does it help with saggy, jowly, or droopy neck and jawline skin?

During the clinical trials on Kybella it was discovered that the treatment did induce new collagen production which in some candidates gave significant skin tightening.  If a lot of neck skin laxity is present, you may consider pairing this treatment with radiofrequency tightening for even treatment of jawline and neck bands with Botox or Dysport.

 

Contact us today for an evaluation if you are interested in the procedure!

 

… Shared by the TDI Team

Loose upper arms? A droopy bottom? TDI’s Body Sculpt to the rescue..

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Body contouring has been steadily growing in popularity (among everyone from celebrities to soccer moms). Nowadays there are various methods for shaping and sculpting the body. With so many options to choose from it can be easy to get confused about what works, what doesn’t and which option is best for you.

First, let’s dispel some myths:

Myth:  Body sculpting just means surgical tummy tucks or liposuction.

Not true!  TDI specializes in non-surgical procedures for specific concerns.  Dr. Chiu will help you set realistic expectations for what you can or cannot achieve with these treatments.

Myth:  There are only one or two spots you can get body contouring.

Body contouring doesn’t just shape and smooth your thighs and tummy. You can get a wide range of areas treated, including neck, upper arms, chest, back, hips, buttocks, knees and even your ankles.  It improves not just fat pockets, but slack skin, and even the appearance of cellulite.

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Non-surgical interventions to keep us confident and comfortable with our skin. There are now more interventions than ever for problem areas even OFF the face. The Derm Institute offers solutions for all areas of the body including tightening loose skin on the upper arms, abdomen, knees, smoothing vertical creasing of the chest, and even non-invasive butt lifting!

You have probably heard some of these names: Coolsculpting, Vanquish, Thermage, Exilis, Cellulaze, Smartlipo. These are all body contouring machines designed to tighten the skin, reduce unwanted fat, and smooth the appearance of cellulite. So what sets TDI’s body sculpting procedures apart?  Dr. Chiu doesn’t just rely soley on a machine and a technician:  she utilizes advanced collagen boosting techniques to make body sculpting more effective and affordable.

At the core of these treatments are Dr. Chiu’s pioneering techniques for off-facial use of Sculptra Aesthetic.  Sculptra is a product made of poly-L-lactic acid, which is utilized to stimulate your own body’s collagen production, lifting, tightening, thickening the collagen, and improving the appearance of treated areas. Facial Rejuvenation with Sculptra is one of our most popular procedures at TDI, but Body Sculpt with Sculptra to improve problem areas off the face is becoming more common among our patients.

Dr. Chiu first developed this technique when she noticed increased laxity and loose skin above her own knees!  In an effort to tighten and lift the area, Dr. Chiu utilized 2 sessions of Sculptra and achieved great results.

Since then, Dr. Chiu has utilized Sculptra to tighten the upper arms in the tricep area, to improve abdomen skin tightness, to rejuvenate thinning loose skin in the inner thigh area, to smooth vertical creasing of the chest, improve laxity in the armpit area, and even lift the buttock area.

 

arm sculptra

Results of Body Sculpt with Sculptra can also be augmented with Radiofrequency Tightening procedures such as Exilis to smooth and tighten lax skin and Vanquish to reduce unwanted fat areas for full effect body sculpting.

If there is any body area that is making you feel self conscious, TDI creates a comfortable environment to let us know.  Explore body sculpt by calling for a consultation today

…Shared by the TDI Team

10 Things You Didn’t Know About Botox

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Botox is increasingly being used in other areas beside the traditional forehead and eye areas.  Newer techniques never “freeze” the muscles, but actually just allows a more relaxed, rested look.  The average spend to treat multiple areas with Botox for patients is around $500-$600, with results lasting 3-4 months.  That is less than having a weekly blowout for your hair!

1. Microdroplet Technique.

Uses tiny amounts of Botox in a wide area instead of traditional injection points to give the face a lifted and tighter appearance, along with reduced pore size.

2. Lifting the Nose Tip.

Aging results in a downturning of the tip of the nose, elongating the look of the nose.  A few drops of Botox in just the right muscle can relift the nose and dramatically change the angle and proportion of the nose to the face.

3. Neck Bands and the Nefertiti Jawline Lift.

We start developing neck banding that pulls down the jawline as early as in our 30s.   Botox, and the other neuromodulators on the market such as Dysport and Xeomin can be used to relax these bands, and allow the jaw to lift.  This is an easy way to tighten the neck, and give definition to a loosening jawline.
Botox-neckbands2 botox-neckbands

4. Botox for Sweating.

Botox can be used to reduce sweating under the arms, on the palms, and even the soles.  Underarm sweating can be reduced for 7 months to 12 months, eliminating the need for deodorant for a lot of our patients!  Our patients swears this procedure pays for itself in drycleaning bills and white or silk shirts not ruined!

5. Botox for Masseter Muscles to Contour the Face, Reduce Teeth Grinding, and Modify TMJ symptoms.

Often patients with a “wider” or more square or jawline is a result of masseter muscle Botox-masseterhypertrophyhypertrophy.  These are the muscles we overuse when grinding the teeth.  Treating these muscles with Botox can reduce the grinding and help with TMJ discomfort.  For those with a bottom heavy or more square jawline, Masseter treatment with Botox can dramatically soften the face and contour a more heart-shaped appearance that is pleasing to the eye.

6. Gummy Smile.

If you notice in photos or with laughing that you have more gum Botox-GummySmileshowing, it may be distracting from a beautiful smile.  Only a couple of expertly placed units can dramatically improve this problem, and makes patients incredibly happy!

7. Downturned Corners of the Mouth.

As we age, the corners of our mouth become more downturned, resulting in a less pleasant and sometimes unhappy appearance.  Requiring only a very small number of units, we can relift the corners of the mouth for a more balanced, relaxed appearance.

8. Smoker’s Lines.

Chronic puckering of the lips can lead to vertical lip lines that age the lower face.  A few units of Botox can help relax these lines and avoid the “smoker’s lines” appearance.  Deeper, etched lines can be treated with a filler like Restylane Silk  along with Botox to relax these muscles.

9. Orange Peel Appearance of the Chin.

Chin dimpling gives an “orange peel” appearance to the chin as the muscles in this area become stronger over time.  Treatment of the mentalis musle in the chin can bring back proportion to the face and smooth the chin.

10. Botox For Oily Skin.

Microdroplets of Botox can be used to reduce chronically oily skin on the face as oil production in sebaceous glands can be reduced by the use of Botox.  The appearance of pores will be tightened as well.

On the Cutting Edge . . . Beauty Breakthroughs on the Horizon

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2015 is set to be an exciting year for new cosmetic procedures. At The Derm Institute, we are always on the cutting edge to deliver the newest and best procedures in Cosmetic Dermatology. Below are soon to be offered brand new procedures to keep you confident and happy in your skin.

1. Restylane Silk for “smoker’s lines”, “lipstick lines”, or vertical lip lines.

Modified 11/22/06 19:03 AlterImage® V3.10Repetitive puckering of the lips from pursing or frequent use of straws and water bottles can cause creasing wrinkles around the mouth area. Restylane Silk was recently approved for use in the United States by the FDA to treat these pesky “smoker’s lines” that age the face. Dr. Chiu is one of the first injectors to offer this product exclusively to TDI patients before its official launch. Restylane Silk differs from classic Restylane, in its particle size. Because of its makeup of finer particles, Restylane Silk will be a “fine line” filler, perfect for those stubborn thin smoker’s lines around the lips, or other fine, shallow lines that can look etched in the skin. The smaller particle allows for a smoother, less bulky fill for a more natural appearance.

Uses:

  • Vertical lip lines or “smokers” lines
  • Etched lines on the cheeks or in the smile area
  • Stubborn forehead or glabellar etching that is not fully treatable with just a neuromodulator such as Botox or Dysport
  • Horizontal necklace lines on the neck area

2. VANQUISH for the thighs, hip area, and arms

At The Derm Institute, we have been getting amazing results around the abdomen, flank, waist, and back with non-invasive fat elimination utilizing radio frequency with the VANQUISH system.  We are now introducing a new subsystem to use the same efficient, yet comfortable technology to treat the thighs, hip area, “saddle bags”, and arms.  Unlike some of the other fat elimination systems in the market, VANQUISH is unique in that it can treat a more comprehensive area:  such as both the inner and outer thigh to reduce the entire thigh circumference if desired.  Treatments will be once a week for 4 weeks, with each treatment lasting about 45 minutes.

Uses:

  • Inner thigh and outer thigh contouring and reduction in fat
  • Reduction in excess fat around the hips or “saddlebags”
  • Inner knee fat pockets
  • Upper arm fat for more attractive contours
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Before
After
After

3. Kythera ATX-101 

This is procedure in late clinical trials with the FDA, with likely launch in early 2015. Kythera ATX-101 is what Dr. Chiu considers a “game changer” in the rejuvenation of the face and neck. The procedure consists of a series of simple injections in the area under the chin and jawline to reduce the fat and sagging that occurs over time. This is a first in class non-invasive cosmetic treatment to better define the jawline by treating the underjaw and underchin fat. Fat is disrupted by ATX-101 and clinical studies show some possible collagen stimulatory effects that tighten the area and allows for a more defined jawline and neck.

Uses:kythera

– For the treatment of a “double chin”

– For the treatment of fullness or jowls around the jawline and neck area

– In expert hands, for the treatment of other small areas of stubborn fat pockets such as the neck and arms.

 

. . . Shared by the TDI Team

Dermarolling For Collagen Induction, A Skin Friendly Treatment

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dermaAcne scars, stretch marks, fine lines, alopecia, the list goes on and on.  All these are common frustrating skin issues that many people want to improve. Along with the long list of skin issues comes an equally long list of treatment options. There is a new, gentle, and affordable technique that has proven to be beneficial for treating a range of these issues, including stubborn acne scars as an affordable adjunct or substitute for lasers and chemical peels.

The Dermaroller, a dermal rolling needle device, has been around for some time, and recently has been proven to achieve a higher efficacy with the rejuvenation of collagen to help assist in the treatment of acne scars, stretch marks, and even alopecia.  The treatment is referred to as Collagen Induction Therapy, or microneedling.  This type of treatment has been proven to aid with neocollagenesis, basically rejuvenating the collagen in areas where it has been depleted or injured such as scars and stretch marks.  Microneedling devices improve texture and tone by inducing teeny microinjuries to the skin.  This process triggers new collagen formation, the release of growth factors, and increased blood flow to bring nutrients to the skin.   It has also been shown to help in skin rejuvenation especially when used in conjunction with good skincare products to improve their penetration, and can even be utilized in office to improve delivery of peels or pigment lightening products.

MTS-1Recent published studies show in-office treatments  performed every two weeks can improve pitted, boxcar acne scarring comparable to laser treatments at a much reduced price point.

Dermarollers come in all different sizes.Leave the large sized ones to a medical professional at our office, where we also have the Rejuvapen, an advanced device that microneedles at a faster rate.  The Derm Institute believes that the most effective treatment combines both in office treatment and at home maintenance.

Ten Reasons to Choose Dermaroller Collagen Induction Therapy

  1. Causes new collagen formation and repair by stimulating the dermis
  2. It can be used on all varieties of skin, even darker skin types or those with sensitive skin!
  3. Treatment completely preserves the epidermis, minimizing downtime and side effects
  4. Can be used on patients who have had laser resurfacing treatments or in conjunction with laser treatments, peels, or pigment brightening treatments
  5. Comfortable procedure
  6. Can be performed on areas of skin where laser treatments cannot reach, such as the delicate fine-line areas around the eyes or stubborn vertical “smokers lines” around the mouth
  7. Only 24-48 hour healing time
  8. Improves the penetration of active topical products applied to the skin
  9. You can use a dermaroller at home
  10. It is extremely cost effective

The Derm Institute has added Collagen Induction Therapy for patients  looking for either additional adjunctive treatment to lasers and peels or who want a very minimally invasive form of treatment that produces clinically significant esults, and still be budget conscious. Please don’t hesitate to call the office or contact us here to learn more about this treatment. The Derm Institute also offers dermarollers for home use in our Skin Boutique. These personal sized dermarollers are easy to use and can benefit patients in-between treatments for faster and better results, or to augment any anti-aging and anti-pigment or skin lightening regimen.  Come and see for yourself soon!

Before & After

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BeforeandAfter_MTS-1

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. . . Shared by the TDI team

Fillers: A weapon to banish “smoker’s lines” or vertical lines around the lips

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One of the most common complaints we hear from patients is the appearance over time of vertical lip lines, commonly referred to as “smoker’s lines” or “lipstick lines”. These stubborn wrinkles are caused by a variety of factors, including age, genetics, repetitive lifestyle habits, and in some individuals, smoking.

Vertical lip lines, or wrinkles around the lips are oftensmokers lines before and after rest-1 NOT caused by smoking, despite its common reference as smokers lines. In fact, they are mostly caused by repetitive regular lip movements, and in some individuals, this movement can be hard to avoid. These lines are noticeable when lipstick “bleeds” into these fine lines, which earns these wrinkles their other common name “lipstick lines.”

As with all wrinkles, preventing their formation or deeper etching of these lines is the first line of defense.

  • Use sunscreen regularly to protect collagen breakdown
  • Stop smoking, if you do smoke. Even occasional smoking greatly expedites the formation of these lines!
  • Frequent use of straws or drinking from a water bottle nozzle causes the firm pursing of the lips that can lead to these lines! Drink from a glass, or from pour bottles of water instead of the sports topped bottles.

Vertical Lip Lines Treatment

Once these vertical lip lines develop, treatment usually requires a soft approach so the area still looks natural, but without the lines.

Fillers such as RHA and Belotero are extremely thin and flexible, making them the best options to treat these pesky wrinkles. Softer, thinner hyaluronic acid based fillers can provide a smoothing of these vertical lip lines without adding any bulk or volume to the lip itself. Fillers used in lip lines are composed of hyaluronic acid, a naturally occurring sugar molecule in the body. Our natural supply of hyaluronic acid diminishes over time with age, and fine lines and loss of collagen occurs as a result. Fillers with small particle sizes and increased flexibility like the RHA 1 fillers are uniquely formulated to re-deliver this naturally hydrating substance to minimize fine vertical smoker’s lines while still allowing fully natural movement in the lip area. Contact us to get a consultation with Dr. Chiu to choose the most customized, natural-feeling filler for your desired outcome.

In FDA studies, 98% of participants treated with fillers in this area reported an improvement in lip wrinkles. Over 75% of subjects still showed improvement 9 months after their initial injection. There is no downtime to the procedure, and the treatment takes approximately 30 minutes.

Other Treatment Modalities

Because “smokers lines” are so pesky, sometimes multiple treatment methods may be needed to result in complete correction.

  • We often use very small, expertly injected amounts of Botox around the mouth to relax the repetitive pursing that causes etching or deepening of these lines. This not only helps the appearance of smoker’s lines by relaxing the muscles that cause vertical lip lines, but it can also improve the longevity of a product like Restylane Silk.
  • Topical creams containing retinoids or polyhydroxy acids can gently resurface and thicken the collagen in the deeper layers of the skin, helping to soften these wrinkles. At The Derm Institute, we love our SkinLab Airbrush Retexurizing Cream, as it contains resurfacing acids and antioxidants to smooth the appearance of fine lines.
  • Physician strength chemical peels can remove the upper layers of the skin, allowing new skin to grow and plump the area, diminishing the appearance of these lines. Deeper peels, including phenol, TCA, and Baker-Gordon-Phenol are handled only by Dr. Chiu can be effective to soften this area around the mouth.
  • Microneedling promotes neocollagenesis, or the production of new collagen stimulated by microinjury induced by tiny needles to soften fine lines and improve skin texture. This is a great, cost effective way to treat this area.
  • Platelet rich plasma (PRP) injections can help improve and smooth the skin in this delicate area.
  • Lasers can cause microzones of collagen repair which resurface vertical lip lines.

Subtle, artful, and expert treatment is key, as this area can easily look “done” or overfilled. But in experienced hands, smokers’ lines can be totally banished without any evidence that a procedure was done. Dr. Chiu is an injector trainer and renown expert in the use of injectable fillers. Contact us today for a consultation.

. . . Shared by the TDI team

TDI’s Quickie Guide to Lasers

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LZR_-1Lasers are an ever growing and changing technology using beams of energy to target unwanted skin conditions. Fractional Ablative and Fractional Non-Ablative resurfacing produces finite columns of treated areas in a gridlike fashion, leaving small islands of normal skin intact to shorten healing time and decrease the risk of pigmentation problems.

Lasers

  • Reverse Premature photodamage and aging
  • Stimulate and tighten new collagen production
  • Improves texture, pore size, scars, and stretch marks

acne_12Ablative lasers are meant to target deeper wrinkles,discoloration and photodamage. Fractionated non-ablative lasers typically produce results with one session with downtime of approximately 7-10 days.

Non-Ablative lasers treat pore size, fine lines, discoloration, scars, as well as stretch marks. Treatment typically requires 3-5 sessions, but downtime is very limited, with only a few days of mild swelling, and a dry, sandpaper like sensation to the skin. Typically makeup can even be worn to cover this.

Fractional laser treatments are one of the Derm Institute’s specialties. There is no cookie-cutter approach–It is important to take into account skin color and ethnic background to achieve the optimal result. Below is a quickie “Cliff’s Notes” guide on lasers.

  1. There is no magic single laser that treats lzr-2everything, pigment, lines, scars, etc are all different targets that sometimes require different lasers. But Fractionated Non-Ablative Lasers comes close to targeting almost all these concerns to smooth and clear the skin.
  2. Fraxel, Artisan, Pearl, Mixto, etc are all name brands utilizing the same type of non-ablative fractional resurfacing technology with slight variations based on provider preference.
  3. These treatments typically require a few sessions but have minimal downtime of approximately 3-7 days.
  4. The Derm Institute recommends strictly following aftercare instructions, including the application of sunscreen or a healing ointment such as Biafine or Aquaphor to reduce downtime.
  5. IPL or Intense Pulsed Light is not technically a laser, but an intensified light source made to target pigment and blood vessels. Downtime is extremely minimal and great results can be achieved in 1-2 sessions.

. . . Shared by the TDI team

The Lifecycle of a Chemical Peel

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Chemical peels are a great way to promote not only exfoliation of the skin but minimization of pores and  long-term collagen boosting effects as well.

Typically on the day of the peel and the say after, the skin looks glowing, refreshed and tightened. On Day 3 and 4 the skin starts flaking, and how much flaking is dependent on the strength of the peel selected by your physician. By Day 6 pores are exfoliated and the skin starts looking refreshed, lines are softened, and pigment is more even. But the longterm effects of collagen boosting last long after the peeling is completed.  When planning a peel, keep these dates in mind. For example if you work during the week, the best days for a peel are Wednesdays and Thursdays if you want the “flaky” days to fall on a weekend.

Most light to moderate peels are best done in a series spaced about 4-6 weeks apart. The results can amplify with regular repetition!  Schedule your peel today!

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Three Tips to Brighten Undereye Circles

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Under eye circles can be caused by a number of different things: lack of sleep, sinus problems, sun exposure, age, allergies, smoking, and even genetics.  The appearance of undereye circles results from where the bone along the orbit of the eye transitions to just skin.  Naturally, there may be a groove in this area that makes the undereye appear hollow, shadowed, and thus darker.  The skin is also very thin in this area, allowing the underlying structure to be seen through the skin.  Blood vessels and muscle can all be slightly seen through thin skin, again making the area appear dark or pigmented.  There are several different approaches to help manage and treat this troublesome issue that many of us suffer from. This includes prevention, treatment, and the benefits of cosmetic procedures for under eye circles. This information will hopefully help you decide which approach (or combination of them!) to take, and which ingredients to look for in products designed to help get rid of those dark circles.

 

1. Prescription Retinols


Products that include a retinol, especially prescription strength retinols such as Renova are an essential part to a good skincare regimen. Retinols helps with cell turnover and collagen synthesis, and can be used for restoring and reviving skin around your eyes by thickening the collagen to help reduce wrinkles and crepy texture. Retinols can be a bit irritating to use, so make sure you follow the correct directions.

 

 

2. Eye brighteners and depuffers


Brightening ingredients such as Vitamin C can reduce the appearance of dark circles by inhibiting melanin which causes pigmentation on the surface of skin.  Eye creams with caffeine also can help reduce puffiness and the appearance of undereye bags.  At The Derm Institute one of our favorite eye creams is Neocutis Bio-Restorative Lumiere Eye Cream, which contains caffeine, for depuffing, Vitamin C for brightening, along with PSPs (or Processed Skin Cell Proteins) that harnesses the power of growth factors and cytokines to boost skin thickness.  It is also packed full of anti-oxidants such as green tea extract to firm the skin This is an ideal all in one product for dark undereye circles and is available for purchase at The Derm Institute.

 

3. Fillers and Peels

One of the most powerful ways to address undereye darkness, circles, and sometimes even puffiness are in-office procedures such as chemical peels and hyaluronic acid injectable fillers.  Products such as Restylane  are sugar molecule gels that can be administered under the eye through a syringe, leaving the undereye area lifted and brightened dramatically. By adding volume back into the undereye, the skin here can be filled in to smooth out any negative contours, effectively eliminating the dark color and shadowing, and erasing the perceived tired look.  Not all dermal fillers can be injected in this area, as have more of a tendency to lump than others.  Placement is also extremely important, as too superficial placement can lead to a bluish visible tint under the skin.  Here at The Derm Institute, Dr. Chiu is an injection instructor, and has extensive experience in addressing this area, including the use of microcannula technique to reduce bruising if necessary.

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Physician-grade medium to deep chemical peels including the Phenol Peel can also be used to lift superficial pigmentation, sunspots, address wrinkles and refresh the texture ,

The best part about these procedures is that they can lead to rejuvenation lasting over a year, contact us to find out more!

“Bro•Tox” aka Botox for Men

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1Men have a growing interest in cosmetic dermatologic treatments. Wrinkles don’t just affect women, so it only makes sense that wrinkle treatments can be used by both MEN and women.  BOTOX has been used for cosmetic purposes to relax frown lines and crow’s feet for over  ten years now, and its use in men continues to grow rapidly annually.   Wrinkles are also not the only thing Botox is used for—often men use products such as Botox to decrease sweating, or hyperhidrosis in the armpits or hands.  This can help a socially annoying condition for up to a year!

Men often use BOTOX to get rid of wrinkles, frown lines, and achieve a generally smoother face for a more youthful, rested, and approachable look?  For all you guys who are worried that this procedure is just for women, fret not. BOTOX or “Bro-tox” for men, has seen a 258 percent increase between 2000 and 2010, according to the American Society of Plastic Surgeons.

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Bro-tox, which is the name given for male Botox injections, is on the rise as it is one of the most subtle  non-invasive skin rejuvenation procedures on the market.  The procedure is fast, virtually painless, and easy.   Bro-tox injections leave no signs of having “work done,” and men are able to get the smoothing, lifting and relaxed appearance without facing the stigma associated with cosmetic procedures. According to the American Society of Plastic Surgeons, in 2011 there has been a 56% increase in minimally invasive procedures in men such as brotox injections. The brotox injection is the most popular.   Increasing numbers of guys are considering non-invasive cosmetic procedures to appear more approachable, to stay competitive in an ever younger millennial workforce, and to generally increase their confidence.  Men and women have very differing  facial anatomy. Men’s skin is thicker, with more oil glands and more hair than female skin, and the aging process is different in the two genders. Women have more fat pads in their faces, and as time marches on the fat pads diminish and the skin begins to sag. Because men have less dense fat pads, the sagging process isn’t as apparent, but stronger muscles in the forehead and around the eyes can lead to deeper, etched lines in men. In general, men can be treated with the same Botox techniques as women, but often require more units to treat the larger muscles in their face. The most common cause of an inadequate result in male patients is under-dosing. Forehead lines require care, as many men with horizontal lines have low-positioned eyebrows, and excessive relaxation of the lower frontalis muscle can drop their brows further. Special consideration should be given to the masculine male brow when treating men.  Going to an experienced master injector such as Dr. Chiu is important to avoid a “done” or even feminized appearance.

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BOTOX is a low-concentrated neuromodulator  that blocks nerve impulses, causing the muscle to become temporarily paralyzed. The process relaxes the muscles that cause wrinkles, reducing the appearance of forehead wrinkles, crow’s feet, and frown lines. BOTOX can also be injected into the muscle and within days, the lines in your bow decrease and your brow line is elevated, leaving you a more youthful, relaxed looking face.  Often our patients state that the “11” lines between the brows make them appear angry or unapproachable, and that Botox softens this effect greatly.

Since this is a nonsurgical procedure, you can be in and out in no time. Pop by before work or after the gym for a quick fifteen-minute visit and look younger instantly. Patients are recommended to come every four to six months to receive new BOTOX injections.

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Another great use for Botox is for underarm sweating. Men and women both can benefit from this. Men sweat more than women, and the area of greatest concern is the underarms, although sometimes excessive sweating on the hands and feet can interfere with daily social interactions. The first long-term study of Botox injections in the treatment of the common sweating disorder shows the injections can safely reduce underarm sweat for up to two years. Botox Treatment of the underarm is a very fast (10-15 minutes) and nearly painless procedure when an appropriate numbing cream is applied.  How does Botox reduce underarm sweating? The drugs contained in the Botox treatment will send signals to the nerves to temporarily put a stop to the production of sweat in the underarms.  This is a very safe procedure that is also increasing in popularity.

Botox is one of the most easily administered and highly effective wrinkle treatments, and because of its efficacy, high degree of satisfaction, and affordability.

Our male patients are incredibly happy with their procedures, and we have an over 90% return rate for male patients here at The Derm Institute.  So be excited and encouraged to try it out! — Botox is not just for women!  A cosmetic consultation is all it takes to get the conversation started.

The Lowdown on Those Unsightly Spider Veins

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1Spider veins refer to those pesky red, purple or blue lines that can be seen through the skin. These are actually dilated blood vessels that are turned or twisted. Some appear as short fine lines, others in clusters, and others in the spider web shape.

Spider veins most commonly occur on legs or on the face, but are also found around the ankles and other parts of the body. They can rarely be  painful. The most common complaints are aching and cramping sensations. However, tingling, burning and throbbing feelings are also reported.  When these symptoms exist, you need to talk to your regular doctor and investigate for deeper vein disease.

More commonly, spider veins are just a cosmetic nuisance.  There are preventive measures that can be applied and in combination with treatment options to rid yourself of these unsightly veins.

Many factors can potentially increase a person’s chances of developing spider or varicose veins. These include:

  • Age. As we get older, the valves in your veins may weaken and not work as well to keep blood moving upwards against gravity.2
  • Medical history. Having family members with vein problems also increases your risk.
  • Hormonal changes. These occur during puberty, pregnancy, and menopause.
  • Pregnancy. During pregnancy, there is a huge increase in the amount of blood in the body. This can cause veins to enlarge.
  • Obesity. Being overweight or obese can put extra pressure on your veins.
  • Lack of movement. Sitting or standing for a long time may force your veins to work harder to pump blood to your heart.
  • Sun exposure. This can cause spider veins on the cheeks or nose of a fair-skinned person.

There are some steps you can take to reduce your chances of getting new spider or varicose veins. These same things can help ease discomfort from the ones you already have:

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  • Wear sunscreen to protect your skin from the sun and to limit spider veins on the face.
  • Exercise regularly to improve your leg strength, circulation, and vein strength.
  • Control your weight to avoid placing too much pressure on your legs.
  • Don’t cross your legs for long times when sitting.
  • Elevate your legs when resting as much as possible.
  • Eat a low-salt diet rich in high-fiber foods. Eating less salt can help with the swelling that comes with varicose veins.

Treatment Options for Spider Veins

4For those pink, red and purple veins, Intense Pulsed Light is by far one of the most safe and effective treatments.  Intense Pulsed Light Lasers can be used anywhere on the body especially for small facial veins, which is a favorite of ours here at The Derm Institute. Treatments are quick with minimal discomfort and side effects.  Many vessels can be eradicated in a single treatment.

Another excellent option Sclerotherapy. With this procedure a solution (most commonly Glycerin or Asclera) is injected into the problematic vein, causing irritation in the vein which makes it swell, stick together and causes the blood to clot. Over time, usually a matter of 3 to 6 weeks, the blood vessel becomes scar tissue and fades away. This may take several treatments, but is fairly simple, inexpensive and an out-patient procedure.

Because compliance with support stockings is important for one week after sclerotherapy, these cooler months of February-April is an ideal time to get your legs summer ready!

Obviously, surgery is the most invasive treatment and is usually left as a last resort for the larger deeper varicose veins.

Whether you have developed spider veins through a life change like pregnancy, through heredity, or by any other cause, there are solutions available. Talking to a qualified doctor is the best way to pinpoint the ideal solution for your needs.

For more information on spider vein treatment, take a look at our Pre and Post Sclerotherapy Instructions. You can request a consult online or call us today at 310-939-9800

Fillers vs Freezers • Infographic

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Injectable treatments can plump thin lips, enhance shallow contours, soften facial creases, remove wrinkles and improve the appearance of recessed scars. With little to no recovery time and impressive results, injectables are a valuable alternative to more invasive cosmetic surgeries. If you’re considering your first injectable treatment, you may be wondering which is right for you. Learn more about the two main types of injectable treatments available and how they work.

Injectables-Manhattan-Beach-Infographic

. . . Shared by Dr. Chiu and The Derm Institute Team

Dermal Fillers for Acne Scarring

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Here at The Derm Institute we see many acne patients with wide variations of acne scarring. There are five common types of acne scars:  ice pick acne scars, boxcar acne scars, rolling acne scars, hypertonic acne scars, and keloid acne scars. Ice pick scars are among the most common types of acne scars and are narrow scars that form pits in the skin. Boxcar scars are similar to chicken pox scars and have angular, well-defined edges that make them appear like a box. They create an indentation in the skin and are most often found on the temples or cheeks. Rolling scars create an indentation in the skin that looks like a wave, due to its wide size and shallow depth. Hypertrophic scars create a raised area on the skin within the boundary of the original wound. Unlike most acne scars, these can diminish in size and appearance over time. Keloid scars create a raised area on the skin that extends beyond the boundary of the original wound. Keloid scars are rubbery, firm and sometimes itchy. In many instances, they grow to be larger than the original inflamed blemish.

Dermal fillers are a great way to treat and potentially get rid of certain types of acne scars, being particularly effective for rolling scars and some less defined boxcar scars. They are safe and well tolerated, with great results to fill the depression associated with scars. They are excellent for volume loss caused by acne scarring.

Considering Dermal Fillers

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The dose required for acne scar filling varies and is dependent on the patient’s facial anatomy, the scarring and where the patient wants to get to in terms of desired results. There are also many types of dermal fillers that you want to go through with your dermatologist. At the Derm Institute we recommend to our patients hyaluronic based fillers such as Belotero, Juvederm, or Restylane.

The dermal filler gives great results immediately and also continues to modify over the next few months.  This modification and improvement occurs as a result of the technique of injection of the filler breaking up some scarred down bands, and because the product and technique stimulate collagen modification due to the stretching of the fibroblasts with the dermal filler.

How this works

A topical numbing cream is usually applied to the skin to alleviate any discomfort. Ice is always used to decrease pain and to reduce the risk of bruising. So if you are concerned of feeling any pain from this procedure, you do have relief options.

What to expect during the procedure

First the doctor and patient will have a discussion about which scars will be filled. Often patients have certain scars in particular that disturb them more than others. We want to make sure we focus on these. After the discussion of which scars will be treated, the skin will be cleaned with alcohol, ice will be applied to the area briefly before treatment, the doctor will inject using a very fine needle and then pressure with gauze will be applied.

After the doctor has filled all of the scars which seem suitable for treatment, the patient will be shown the mirror, and then the patient is offered the opportunity to point out further scars that bother them. These will then be filled.

After your treatment

Acne Scar Before and AfterWe will give you a personal ice pack to hold in the areas that are treated. Treated areas may be red, swollen, and bruised for the first 2-7 days. DO NOT get a facial or massage for 1-2 weeks after your dermal filler procedure. AVOID strenuous workouts and alcohol for the 24 hours if possible. If bruising occurs, Arnica supplements or applying arnica gel have been shown to decrease bruising. *Another trick, drinking pineapple juice, and/or take Bromelain supplements is suggested to help bruising resolve faster. Bruising can be covered by make-up.  The Derm Institute recommends Dermablend (available at CVS or Macy’s) or the Colorescience Corrector Palette.

 

Other Methods for Acne Scarring to Consider

Here at The Derm Institute we offer a 360 degree approach to acne scarring. This is why it is very important to go see a board-certified dermatologist to assess your skin type and your specific type of scarring. Punch excisions, TCA cross technique for icepick scars and fractional non-ablative laser are other great option and we often combine different treatments for the best results.

Icepick or pitted scars can be treated with the “TCA CROSS” trichloroacetic acid (TCA) and chemical reconstruction of skin scars (CROSS). TCA Cross is a skin care method in which a very high percentage of TCA is applied to the acne scar tissue only. The TCA Cross method needs to be repeated every 1-2 months so that dermal thickening and collagen production occurs inside the acne scars. After 3-9 months, you should see a great improvement in the appearance of your acne scars!

Fractional non-ablative laser offers both superior results and a little to no downtime! This laser has a hand piece that delivers light in an array of narrow, focused microbeams to create columns of coagulation within the skin. These columns initiate a natural healing process that forms new healthy tissue. This results in an improved skin appearance! Downtime is milder than other lasers, and typically resolves in 3-5 days.

Dermal Fillers show great results and improves the appearance of acne scars by lifting the depressed scars. Their effect is temporary. The results can last from between a few months to a year using fillers such as Belotero, Restylane, Juvederm, and Perlane, etc. However, with a combination of laser treatments such as the fractional non-ablative and very effective chemical peels, this can help dramatically reduce the appearance of acne scars with improvement in overall skin texture and healthy, happy skin.

Dr. Chiu and her medical team are personally involved in every treatment here at The Derm Institute. We are happy to answer any questions you may have about any of the procedures. To learn more about treatments at The Derm Institute or to schedule a free consultation, contact us by phone or email today.

 

. . . Shared by Dr. Chiu and The Derm Institute Team

Tips for Treating Large Pores

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We all want satiny smooth skin, unfortunately big pores often stand in the way of having that. Here is The Derm Institute’s Tips on minimizing the appearance of large pores.

Skin Care Tips There are a number of factors that will cause large pores, but of the many, there are three main culprits. The first one is age. As we age we will naturally lose the elasticity in the surrounding skin that supports the pores, causing pores to appear bigger than they actually are. Secondly, men are more likely to have larger pores compared to women from their genetic makeup and increased oil production. And last but not least, our body uses a substance called Sebum, which naturally hydrates our skin to prevent from drying. This substance however is very oily and individuals who produce more than average will find that oily skin causes larger pores.

 

The good news is you can make your large pores appear smaller and here’s some quick how-to’s:

1.  Cleanse:

One of the easiest and quickest ways to reduce large pores is implementing a daily routine of constantly keeping them clean. Use a mild cleanser twice a day and exfoliate so that your skin doesn’t become overly dry.  You can consider a cleanser that contains a gentle lactic or salicylic acid to declog the pores.

2.  Exfoliate:

Removing dead skin cells from the upper skin layer to brighten skin texture and get rid of heaped up cells surrounding and in the pores.  Removing the dull layer of dead skin cells on top of your living skin layer gives you brighter, smoother, more radiant looking skin with a velvety soft texture.  You may want to think about investing in the Clarisonic Mia which uses sonic energy and the vibrations of a brush to pulse your cleanser down into your pores. Oil and clogged pore debris can then be lifted out of the pores.  Empty pores look cleaner and smaller because the black appearance oxidized pore debris make pores look  more obvious.

3.  Treat: 

The use of topical treatments such as retinoids, salicylic acid, alpha hydroxy acid or benzoyl peroxides will not only reduce the size of the pores but will also aid in the destruction of bacteria that cause acne and treat sun damage.

If you still feel like your pores look big with the tricks I’ve mentioned above. You may need a little extra help. There are many dermatological advances in skincare which has led to the development of a number of effective treatments for large pores. If you have large pores, you may benefit from the following treatments:

4.  Chemical Peels:

Our team at The Derm Institute will work with you to transform your complexion into beautiful, healthy-looking skin. Our chemical peels use varying types of prescription-strength acids including salicylic, lactic, retinol, and trichloroacetic acid to remove your outer layers of dead skin – revealing the fresher, healthier, softer skin underneath.

5.  Fractional Non-Ablative Laser Skin Resurfacing: 

Fractional Non-Ablative Laser Skin Resurfacing works beautifully to create micro-zones of collagen boosting to reveal fresher, smooth skin.  It can minimize the appearance of pores as well as acne scars.  Downtime is minimal with some mild redness and flaking.  Typically a series of even 2 treatments is enough for long-lasting results.

Laser Treatments for Large Pores

View our before and after gallery

6.  IPL Photofacial:

Intense Pulsed Light (IPL) treatments are also fantastic for refining the texture and appearance of pores.  Skin feels incredible after even a single treatment.  IPL causes tightening of the pores, gives the skin an overall glow, and addresses any unwanted red or brown spots.

7.  Photodynamic Therapy:

Photodynamic Therapy uses a light activated solution to improve the skin texture by minimizing the size of oil glands on the face.  Typically 1-2 treatments can address pore size significantly, as well as reducing signs of early sun damage.

8.  Smart Makeup:

If you suffer from large pores your first instinct may to immediately reach for that makeup bag to reduce their appearance. But wait! Before you rush into it, double check that you are using the correct products first. What you want is a product that is an oil free formula without a lot of talc, which can actually settle into the pores and make them appear larger.

Dr. Chiu and her medical team are personally involved in every treatment here at The Derm Institute. We are happy to answer any questions you may have about any of the procedures. To learn more about treatments at The Derm Institute or to schedule a free consultation, contact us by phone or email today.

 

. . . Shared by Dr. Chiu and The Derm Institute Team

 

6 Steps to Soft, Smooth Skin!

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Whether you want to fade fine lines, get rid of flaky patches, or just up your overall glow, these six procedures can help. From anti-wrinkle procedures to skin-sloughing treatments, here are six ways to keep your skin smooth starting this New Year.

1. Start with something basic, like moisturizer. Some moisturizers are not very moisturizing. A lotion may smell good and look nice, but if you can’t tell you put it on five minutes after you put it on, it’s not doing much. Dr. Annie Chiu recommends switching to heavier, thicker products that contain humectants, which attract moisture to skin, when the weather gets colder. One of our favorite’s at The Derm Institute is, SkinMedica’s Dermal Repair, it works like a multi-vitamin for the skin by using nourishing ingredients to support the skin’s barrier and improve signs of dry aging skin. SkinMedica’s Dermal Repair Cream offers intense skin hydration and helps replenish firmness and moisture.shaving legs

2. Shaving. In the morning: Many women shave their legs with regular bar soap. But soap plus the calcium in hard water forms a gummy coating and makes skin drier than soap alone. Use a body wash, a soap alternative. *The Derm Institute Tip: Shave every day to every other day, with a body wash or shaving cream, with warm not hot water. A razor removes the protective top layers of your skin, along with hair. When you do de-fuzz, choose a four-blade razor — it offers the closest shave, allowing you to use a gentle hand, which preserves natural moisture — and opt for a hydrating shaving cream, not gel.

3. Chemical Peels, a common cosmetic procedure, works by removing your skin’s outer layer by exfoliating the skin and removing dead cells on the surface. Dr. Chiu’s Physicians Blends allows you to enhance exfoliation to promote a healthy, more radiant layer of skin while boosting collagen production. Most peels can be used on any part of the body, the most popular being the face, neck, décolleté, arms and hands.

4. Intense Pulsed Light (IPL) Photofacial to address any brown spots or broken blood vessels. Dr. Chiu’s IPL Photofacial utilizes Intense Pulsed Light for a gentle treatment that is safe, painless, and requires no significant recovery time. IPL sends light through the skin to target the undesirable tissue, and leaves the surrounding tissue unharmed. The process is gradual and, collagen production is stimulated, rejuvenating the skin, shrinking pores, and giving the skin an overall glow. After about 5 days of very minimal “beauty downtime”, this procedure will reveal new glowing skin with improved texture, pores and decreased wrinkles. The result is healthier, younger looking skin.

5. Photodynamic Therapy. The Derm Institute uses a LED (light-emitting diode) that healthy-skin-winterproduces a narrow spectrum light to boost collagen, which creates plumper, younger-looking skin, or to kill the bacteria that causes acne. LED photo facials are painless, cool and relaxing, and carry no risks. The best results come after a series of photo facial treatments. LED photo facials are a good choice for people who want to boost collagen or treat acne. Their collagen-boosting, facial rejuvenation properties have been proven with medical research. The results won’t be as dramatic as plastic surgery, but it’s a gentler, more natural, less expensive way to go.

6. If you’re not wearing sunscreen: Start now. It won’t get rid of the lines you have, but it will prevent new ones from forming. Begin using a prescription retinoid cream nightly; Dr. Chiu often recommends Renova because patients find it less drying than other formulas. You’ll notice lines softening in two to three months.

 

If you want to be more aggressive, you could try Botox, a favorite here at The Derm Institute. Botox is a botulinum toxin that blocks the nerve impulses that cause muscle activity—and expression lines. Dr. Chiu can inject it around the eyes, between the brows, across the forehead; the lines in those areas then fade away over about a week. Fine lines are generally about 20 percent genetic and 80 percent environmental (in other words, brought on by the sun and smoking). They usually occur in the most expressive areas of your face—like around the eyes and forehead.

 

. . . Shared by Dr. Chiu and The Derm Institute Team