fort-walton Archives | The Aesthetic Clinique

Treating Post Inflammatory Hyperpigmentation (PIH)

Melanocytes are the cells responsible for the pigmentation in the skin. Their activity can be increased in response to inflammation. When skin becomes hyperpigmented from an injury, it is called “post inflammatory hyperpigmentation” or PIH. This is particularly prevalent in darker skin individuals, where there is more melanocytic activity, but can occur in lighter skin individuals as well.

The widely accepted scale for skin pigmentation types is the Fitzpatrick Scale. The Fitzpatrick Skin Type 1 are extremely light skinned, have blue eyes, and burn extremely rapidly with sun exposure. Type 6 individuals have very dark skin, dark eyes, and tolerate prolonged sun exposure without burning. In general, the type 4-6 skin types are the ones at risk for PIH.

PIH is possible after the following:

Laser procedures (mainly laser resurfacing)
Acne
Surgical incisions
Chemical peels
Burns
Infections
Radiofrequency (Infini is low risk)

The best way to treat PIH is prevention, if possible. Prevention consists of calming down the melanocyte metabolism. The standard recommendations are Retin A and hydroquinones. If there is a procedure a darker skin individual is planning that has risks of PIH, this regime should be started at 3 weeks prior to the procedure. It should be continued at least a month and up to 3 months afterwards. These 2 topicals are also standard therapy for patients with PIH.

Prolonged inflammation after a procedure (more than a week) in a darker skin individual, is a risk for PIH. The practitioner needs to recognize this and treat the inflammation appropriately. If there is prolonged redness of the skin, steroids and/or vascular lasers are needed to reduce this. If infection suspected, antibiotics are needed. Calming the skin is essential to prevent PIH.

The timing of PIH is very predictable. It almost always occurs about 3 weeks after a “at risk” procedure is performed.

If there is already PIH, treatments which can be used are:

Topicals such as Retin A, hydroquinone, and steroids; Triluma contains all 3
Chemical Peels
Gentle laser treatments with a 1064 laser (nanosecond or picosecond)
Possibly PRP with microneedling (experimental but minimal risk)
Antibiotics for ongoing infections
Laser hair removal for PIH associated with folliculitis

In general, PIH is best prevented then trying to treat after it occurs. Recognizing risk factors with certain procedures is the key to success. Treating prolonged redness is often overlooked and must be treated aggressively rather than taking a “wait and see” approach.

For Restylane Silk…Size Matters…Smaller is Better

Lip Enhancement with Restylane Silk.

Traumatic Lip before Restylane Silk Treatment

One Day after Restylane Silk Treatment

Dr. Weiner performing Lip Enhancement with Restylane Silk – Before

Immediately after Dr. Weiner injected Restylane Silk

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Restylane has become the number one trusted dermal filler in the world. With over 20 million treatments worldwide, and numerous publish studies, Restylane’s safety and efficacy is well established. It is composed of hyaluronic acid (HA), a naturally occurring substance that is found in skin and joints. It’s duration of action is about 6-12 months, depending on the location it is placed. (My other blog explains duration in more detail) Crosslinking, a process that joins adjacent strands of the HA, is essential, because the breakdown of the HA would occur in weeks without it.

Restylane is composed of similarly sized HA particles, with a concentration of 100,000 per ml. Perlane, a “cousin” of Restylane, is exactly the same as Restylane, except that it’s concentration is 10,000 particles per ml. Both of these products have been on the US market for years, Restylane since 2005, and Perlane since 2007. Restylane Silk, the newest US FDA approved filler, is composed of 500,000 HA particles per ml.

This means that the Restylane Silk HA particle is 1/5th the size of the regular Restylane HA particle, and that’s the reason behind it’s magic.

Although Restylane Silk was approved in the US in 2014, it has been used under the name Restylane Fine Lines for over 15 years in Canada. There has been a huge experience in Canada using this product to improve superficial fine lines and in LIP ENHANCEMENT. In the US, there are now only 2 FDA approved fillers for the lips, Restylane, and Restylane Silk. Silk is also approved for the perioral area (area around the mouth). It’s the author’s opinion that part of the problem lip enhancement has been disappointing to many patients is that US physicians didn’t have access to the proper filler. Fish lips, sausage lips, uneven lips, overfilled lips have dissuaded many potential patients from ever trying lip enhancement.

The small particle size of Restylane Silk allows the skilled and experienced physician to add product in the very superficial aspect of the lip, in the submucosa. This was impossible with other fillers without lumps being visible. The product spreads in this plane, so only a couple points of injection are needed in each quadrant of the lip. By being so superficial, and with only a couple injection points, the discomfort associated with the injection is markedly decreased. In addition, by staying superficial, and not deep, the risk of a bruise is significantly less. Very precise alloquots of Restylane Silk can be placed along the border of the lip (vermillion), cupids bow and peaks, in the tubercles, and corners of the mouth much easier than the larger particle HA fillers.

The addition of Restylane Silk to the aesthetic physician’s armamentarium fills a necessary niche that was missing in lip enhancement. Patients can now anticipate less bruising, less discomfort, less lumps, with better and more natural results, thanks to the smaller particle size of Restylane Silk.

Blog: http://stevenfweinermd.wordpress.com/

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Website: http://www.theclinique.net

Facebook: http://www.facebook.com/TheAestheticClinique/

Fractional Coagulation is in, Bulk Heating is out for Radiofrequency (RF) Skin Tightening

Ever since Rox Anderson suggested that treating a portion (fraction) of skin while leaving untreated healthy tissue behind as the basis for the Fraxel Skin resurfacing laser over 10 years ago, patients have been having less downtime, less risk, and less discomfort with their laser procedures. Healing is dramatically improved because the adjacent nontreated dermis is able to provide the needed blood supply, nutrients, and local immune response much faster than the traditional treatments and results have been shown to be very similar in efficacy.

Until recently, all RF devices have applied heat to the skin/dermis in a nonfractionated approach, called “Bulk Heating”. Whether the RF device is Bipolar or Monopolar, if the heating element does not penetrate the skin, the energy is pushed into the deeper layers using this method. The implication of bulk heating is that all precision is lost. Exact placement of the heat is impossible, with large opportunities for errors in depth of penetration and/or temperature control. When treating skin, heat from the RF device using bulk heating can be placed too superficial, leading to burns or pigmentation changes, or too deep, leading to fat loss. The dermis needs to be heated to 42 degrees C for 3 minutes to affect collagen stimulation. Only if skin temperature is measured can the operator be sure that the 42 degrees is reached with bulk heating, which is not the case for most bulk heating devices. One last temperature issue is that bulk heating devices are unable to obtain coagulation of the tissue, which occurs at about 67 degrees C, which is needed for maximal tissue contraction and collagen stimulation.

The Infini uses microneedles to deliver the radiofrequency energy IN A FRACTIONAL manner. Its unique array of needles allows the energy to flow between the needles, creating 49 coagulation points AT A SPECIFIED DEPTH in the dermis. Surrounding tissue is sparred, which makes for very little downtime. The superficial layer of skin is spared (because the needles are insulated), leading to no wound care, and markedly reduced risk of burns and pigmentation issues affecting the epidermis. The temperature created in the areas between the needle is enough to create coagulation, for maximal tissue contraction and collagen stimulation.

(Not all microneedling RF devices are fractional. Fractora uses microneedles, but because the energy is directed from the needles to the skin surface, the heating is in a fashion similar to bulk heating devices. Also, because more tissue is affected using this heating method, discomfort is much higher and local anesthetic needs to be injected in most cases.)

It has taken a long time for RF devices to catch on to the fractional technology revolution. The Infini has created much more precision in the delivery of RF energy to the dermis, allowing for higher degrees of skin tightening, while affording the safety and quick recovery time that fractional technology has created.

All Botox Providers are NOT the same. Choose carefully!

Botox injections are the most popular cosmetic procedure performed worldwide. Millions of patients are injected each year with the wrinkle fighting drug. Its popularity is attributed to:

There is minimal downtime – 15 minutes of bumps from the injection
The procedure is highly effective in improving wrinkles
Discomfort is usually minimal
Side effects are few and rare
Cost is fairly reasonably, but depends on how many areas are done
The time it takes to get a treatment is less than 10 minutes

So why is the “Was it Worth It” review on Realself.com for Botox only 69%? This can be attributed to multiple reasons, which be further elaborated upon in this blog. (A large volume practice should have a satisfaction rate in the >95%.)

Although the Botox procedure looks very routine to the observer/client, don’t equate this to being a simple procedure that all injectors can master easily.

All patients will age differently, so what areas need treating for optimal cosmetic results needs to be tailored specifically to each patient. A cookie cutter approach to every patient will not work. There are several areas of the face which can be considered advanced: lips, corners of mouth, neck, gummy smile, under eye, bunny lines, inner eyebrows which require a highly trained and experienced injector, or you will live with a disfiguring facial appearance for 3 months.

The trend is moving away from the frozen, no movement, very obviously treated face to a more natural appearance. Rather than blasting and overwhelming the forehead with Botox, a technique using very small, precisionly placed aliquots that allows for movement but with diminished wrinkles. This is a more difficult technique to master.

Shortcuts are often routine in regards to Botox. A majority of practices will draw up syringes of Botox in the morning, or the day before, by a nurse, medical assistant, or office staff. That means the patient will need to get injected in multiples of what is contained in a syringe, leading to limited customization. Also, errors in dilution and sterile technique are possible when filling the syringes is not done by the same person that is injecting the Botox. (Botox comes in a powder form and needs to have saline added to reconstitute it to become an injectable solution.) Dr. Weiner mixes all his Botox personally, and will draw up the appropriate amounts for each patient in the room, just prior to injection.

Discomfort related to the injection can be minimized using various techniques. Using preserved saline has been shown to result in less pain than using regular saline. Needle size, speed of injection, and using proper needle placement is also a key factor affecting comfort. Dr. Weiner also uses several distraction techniques, capitalizing on the Gate Theory (the brain has difficulty processing more than one sensory input at the same time).

Varying the concentration of Botox is a technique Dr. Weiner has used for years. Certain areas require different dilutions to lead to maximal cosmetic benefits.

Touch ups to correct minor imperfections require an advanced injectors experience. They also need a responsive provider, easily available for a drop in or work in patient.

Getting injected by an unknown provider at someone’s Botox party, is never a good idea, and almost always leads to problems that one has to live with for 3 months. The “savings” never is worth it.

Although Botox is extremely popular, as the Realself.com stats show, there are many people that are not pleased with their experience. This is not the norm for the high volume, experienced injector. As explained above, there are many intricacies which can contribute to better results. Hopefully the public will understand that Botox should not be considered a routine cosmetic procedure, and they need to select their providers carefully.

Beauty and Skin Tips for those on a budget.

This blog will elucidate that small changes to one’s lifestyle and a small investment in skin products, will lead to significant improvements in one’s skin health and beauty.

Protect from the sun with daily sunscreen, sun protection, and Heliocare. The number one enemy to skin is sun exposure. The sun’s UVB rays lead to activation of enzymes that destroy the skin’s collagen leading to wrinkling and thinner skin. Skin pigmentation problems (melasma, solar lentigos) are exacerbated by the sun. Skin cancers are almost always related to exposure to the sun’s damaging rays. Studies have shown that just using sunscreen can improve ones looks. Heliocare contains Polypodium leucotomos which is a fern extract that is an antioxidant that reverses and protects against the radiation effects of the sun on skin cells. Heliocare has also been shown to improve melasma, because even indoor artificial light can exacerbate this condition where sunscreens don’t offer protection. Wearing a large brimmed hat, SPF rash guard (if at the beach), and staying under an umbrella/shade should be considered during periods of prolonged outdoor sun exposure.
Stop smoking. Smoking is probably a close second to the sun as a factor affecting skin health and beauty. The toxins in smoking cause contraction in vessels in the skin, leading to poor oxygenation of the skin cells. Smoking essentially strangulates one’s skin causing loss of elasticity, viability, and thickness. Other side effects include increased wrinkles, a change in the color of the skin, thinning of the hair, halitosis, and dental disease.
Apply topical Retin A or Retinol. It has been well established with research dating back over 25 years, that Retin A has anti-aging qualities. It has been shown to increase cellular turnover in the skin, thus creating skin cells that are younger and more vibrant. It increases collagen in the skin and improves hydration in the skin by increasing the GAG’s. Pigmentation abnormalities are improved as well. Precancerous changes are reversed and prevented to a certain extent. Wrinkles and photodamage have been shown to improve with just using Retin A. One word of caution. If you choose to use Retinol because it has less peeling, you have to use a strength that is higher than what is found in most OTC cosmetics.
Maintain hydration, drink plenty of water. This is somewhat controversial, but there are anecdotal reports of improvements in overall looks with just making sure you are fully hydrated. There are obvious other benefits as well including kidney, bladder, blood pressure and circulatory health.
Topical Growth Factors and Antioxidants. Growth factors stimulate skin cells to become more youthful and recruit stem cells which may lay dormant in the skin. Antioxidants help the skin fight off the environmental stress that attacks the skin, including the sun’s damaging radiation. Products that fall into this category are: TNS Essential Serum, Lifeline Day and Night Cream, and Neocutis Journee.

These recommendations are a good start to improve skin health for all individuals, regardless of budgetary concerns. The younger these are implemented, the less correction that will be needed in the future. Consider following these guidelines as an “investment in the future”.

Slimming Ones Facial Appearance with Botox/Dysport

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The ideal shape for an aesthetically pleasing face has been referred to as “an upside down egg” or heart-shaped. It is desirous to have the upper face wider than the mid/lower face. It brings more attention to the eyes, the center of beauty. Widening of the lower face can give a female a more masculine appearance, and also is a sign of aging. The causes of enlargement of the mid/lower face are:

Enlarged masseter muscles. Often caused by bruxism (grinding one’s teeth)
Obesity
Genetics. Asian females tend to have this issue
Jowling associated with the aging face

By injecting the masseter muscles with Botox or Dysport, the muscles can diminish in size and atrophy over time. If the procedure is repeated and regularly administered, a long-term slimming of the mid and lower face can be achieved. Candidates for this procedure are people who fall into the #1 and #3 category. Risks are minimal, but this can affect your smile if not done by someone who has experience with the anatomy and performing this procedure.

Many people would also benefit from injecting the temples simultaneously with filler to help create the upside down egg-shape to the face (from a square-shaped face).

For the person that falls into the #2 and #4 category, there is some literature that suggests that Ulthera might be helpful. Although a much newer technology, Infini might work for this as well, time will tell. By going to depths that are much deeper than the skin, into the fat layer, it might be possible to decrease the amount of fat in these areas and thereby slim the face.

Recent Advances in Coolsculpting – 2014

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Coolsculpting is a noninvasive technique to permanently reduce unwanted fat. It was FDA approved in 2009 for treatment of the flanks. It has subsequently been FDA approved for abdominal fat and, as of April, 2014, has the indication for treating thighs.

Up until this point, all the handpieces required a suction to adhere to the area that was going to be treated. There needed to be a roll of fat that could be “grabbed” by the suction or the area couldn’t be treated. The development of the newest handpiece, the Coolsmooth, allowed for areas to be treated without the use of the suction, such as the thigh area. It also enabled the person with smaller amounts of fat or tighter skin to be treated. At the present time, each application of the Coolsmooth handpiece requires 2 hours but this will most likely be reduced to 1 hour in the future.

“Treatment to transformation” is a technique whereby multiple applications of the Coolsculpting machine are applied in either one or several sittings. By overlapping areas treated or by treating some areas 2 or 3 times, results are now approaching what liposuction can achieve – without the downtime or risk associated. The technique has been pioneered by Dr. Grant Stevens, from Marina del Ray, California.

Massaging immediately after removal of the handpiece has been shown to increase the fat loss in a recent study. This has been done in our office for at least 4 years.

Although loose skin is a theoretical risk after losing fat underneath it, Dr. Stevens has shown that this is absolutely not the case. He has seen skin contraction with his patients and has not seen cases of excess skin.

A recent study presented at ASLMS 2014 showed effectiveness in patients with gynecomastia. Two treatments were required and most patients were satisfied with their results.

Future handpieces are being developed to work on the neck/chin area, ankles, and one specifically for breast tissue. Cellulite reduction is also being studied and it looks promising. Treatment for uneven results after liposuction seems to be greatly improved with Coolsculpting as well, and the new Coolsmooth handpiece will be a huge advance in this treatment.

Hyaluronidase – The “Magic Eraser” for Hyaluronic Acid (Juvederm, Restylane, Voluma) Dermal Fillers

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Hyaluronic Acid dermal fillers are the most popular fillers used worldwide. In the United States, the commonly used HA fillers are:

Juvederm Ultra and Ultra Plus
Voluma
Restylane
Restylane Lyft (Perlane)
Restylane Silk
Belotero

The beauty of HA fillers is that they are very well tolerated because hyaluronic acid is a component of skin, so it is a naturally occurring substance. It’s a soft product, and will last anywhere from 4 months, to up to 2 years, depending on the brand used, and the location it is placed.

Another key attribute to the HA fillers popularity is that it can be completely dissolved with an enzyme called hyaluronidase. It is manufactured from either bovine (cow) or ovine (sheep), so there is a remote possibility of having an allergic reaction to the commercially available products (Vitrase, Hydase, and Amphadase). There seems to be a crossover with people that are allergic to bees for these animal derived products. Hylenex is a recombinant form of hyaluronidase that is the human form that is the preferred form of Dr. Weiner for there are no allergies, yet it is a bit more expensive.

Hyaluronidase is useful for dissolving HA filler in the following instances:

The filler was over done/”over filled” and it is not aesthetically pleasing
There is prolonged swelling, particularly around the eye and most often with Juvederm
An infection has occurred in the area of prior filler
The filler is lumpy or has nodules and doesn’t respond to massage and time (especially lips)
Rare possible allergic reaction to the HA filler
When there is vascular compromise secondary to the HA filler injection which can be caused by external compression on a vessel or intraluminal (within the vessel) injection

My experience with hyaluronidase has been mostly with patients that have had Juvederm injected in the tear trough area from another facility. I strongly recommend that Juvederm not be injected in this area because of the risk of prolonged edema. The reason this happens more with Juvederm is speculated to be due to its ability to attract more water, higher concentration of HA in the product, and because it spreads more diffusely than the other fillers.

When injecting emergently for vascular compromise, at least 200 units (more is better) should be injected in and around the original site of injection of the HA. It has been shown that extravascular hyaluronidase is able to traverse the vessel wall to make it intraluminal, useful knowledge for the cases where the HA is within the vessel. (Blindness needs emergent Ophthalmology evaluation and might require arteriogram for placement of hyaluronidase. Even with such extraordinary measures, blindness is almost always permanent.)

When injecting hyaluronidase, it is mixed with lidocaine by the physician, so it is a fairly comfortable procedure. There are a couple limiting factors with the injection. It is not as precise as the filler injection, so it can remove some of the filler that you wanted to stay along with the unwanted filler. Also, dosing/how much to use, is not an exact science. It may take more than one treatment to dissolve the HA filler. The results can occur within minutes, but usually take about a day to fully appreciate. Also, Juvederm and Voluma tend to be the hardest to dissolve, and it is thought that this is related to the way it is cross linked (manufacturing process).

The bottom line is that you don’t have to live with HA filler that you are not happy with. You can easily reverse lips that are lumpy or too big, swelling around the eye from filler, or dissolve an over correction or asymmetry with hyaluronidase. An injection with hyaluronidase can get you back to where you used to be in about 24 hours. Also, it’s nice to have a little piece of mind when getting injected with an HA filler that the process can be completely reversed with a small procedure.

Dr. Steve Weiner is a Facial Plastic Surgeon who “laid down his scalpel” in 2005 and concentrates solely on non invasive and minimally invasive cosmetic procedures at The Aesthetic Clinique. His website is http://www.theclinique.net . Call for a consultation: 850.622.1214

Blog: http://stevenfweinermd.wordpress.com/

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Revance (RVNC) RT001 is Going to Improve Crows Feet and Sweating WITHOUT Needles

Revance Therapuetics, RVNC

Revance RT001 is a topical treatment that is a neurotoxin or “neuromodulator”. This means that it decreases the muscle activity, similar to Botox Cosmetic, Dysport, and Xeomin. However, unlike the current FDA neuromodulators, Revance RT001 can penetrate through intact skin, whereas all the others require needle injections. Although the Botox injections are fairly quick and cause minimal discomfort, it is the belief by the company, Revance (RVNC), that there are many people that are avoiding treatment because of the needles. It has been reported that only 10% of the candidates for getting their crows feet treated are currently getting treated and that when offered a topical, the number of people getting treated will go up significantly. Unfortunately, the only area that has shown promise on the face in their studies has been the crows feet. The frown lines (glabella) treatment was not significantly improved with Revance RT001, and that’s most likely related to differences in the position of the muscles in this area (deep) when compared to the crows feet (superficial).

Revance topical treatment, RT001

The treatment will be applied in the doctors office and will need to stay on the skin for approximately 20 minutes. This will NOT be a home remedy. Results might actually be better than the injections, for the crows feet, because the application will be more uniform to the area as opposed to the injections which are done in a sequential, interrupted manner.

Another use of Revance RT001 being researched is for excessive sweating, hyperhidrosis, in the underarm (axilla). Treating this area with the injectable neurotoxins (Botox, Dysport) requires about 30 punctures on each side. Clearly, Revance will be a huge step forward in comfort for patients being treated for this problem. A growing trend has been using Botox to treat genital/pubic area sweat. Needless to say, most people would prefer topicals in this area to several injections. It doesn’t seem to be effective in the hands or feet at this time because the thickness of the dermis prevents proper absorption of the drug through the skin. Research is also being done on its use for improving acne.

It looks like Revance RT001 will get FDA approval because of its great safety and efficacy in their current FDA trials. When will it get approved? Probably late 2014 or early 2015. This will be a welcome relief to all the needle-phobes with prominent crows feet.

Dr. Weiner is a Facial Plastic Surgeon who laid down his scalpel in 2005 and concentrates solely on noninvasive and minimally invasive Cosmetic Procedures. He is Johns Hopkins trained and Board Certified.

Website: http://www.theclinique.net

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Facebook: https://www.facebook.com/TheAestheticClinique

Hair and Eyebrow Restoration Completely NonSurgical using PRP and ACell

PRP was injected for hair regeneration, from Prime Journal article

PRP was injected for hair restoration, from Prime Journal article, one treatment

PRP was injected for alopecia areata. From Prime Journal, one treatment

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PRP is “Platelet Rich Plasma”, a portion of whole blood that is separated from the red blood cells through centrifuging. It should contain concentrations of platelets that are at least 4 times that of what is found in whole blood to get the maximum benefits. Its use in medical conditions started in the 1990’s mainly by Orthopedic Surgeons, Dentists, and Oral Surgeons, but has recently been expanded to the Cosmetic Surgery arena.

(Please note: Not all PRP is the same! Most PRP systems don’t get the concentration of the platelets above the 4x level needed to get the full benefits from PRP. The system that has proven to have consistent 4-7x concentrations is the Magellan “TruPRP” system. It cost much more that the other systems, but the results will be superior to all other PRP systems available on the market. In a recent lecture that Dr. Weiner attended in Paris at IMCAS 2014, 13 different PRP machines were evaluated. Some systems didn’t even result in platelets that had higher concentrations than whole blood!)

When an injury occurs in the body, platelets are the “first responders”. Platelets have been found to contain the following growth factors and cytokines:

Platelet derived growth factors
Transforming growth factor beta
Fibroblast growth factor
Insulin-like growth factor 1
Insulin-like growth factor 2
Vascular endothelial growth factor
Epidermal growth factor
Interleukin 8
Keratinocyte growth factor
Connective tissue growth factor

PRP use in hair restoration began during hair transplantation 5-7 years ago. Surgeons found that bathing the harvested hair follicles led to improvements in the “take” of the transplanted follicle as well as more hair growth, and denser hair growth. Injecting PRP in the harvested area led to improved healing of the scar. It was then discovered that when PRP was then injected into areas of hair loss without transplanting hair, that there was new hair growth. Adding ACell (a derivative of porcine bladder) and Vitamin D3 and B complex gave even further improvements. In a study published in “Prime” Journal, patients were found to have improvements in their hair growth from 12-63%, and notably, there was improvements in all the patients studied. Growth seems to start at about 4 months, and starts to fade at about 11 months. Improvements are more dramatic in females than in males.

The mechanism proposed for the improvements seen is that the PRP leads to increased vascularization of the hair follicles, leading to a “waking up” of previously poorly perfused hair follicles. The growth factors also stimulate the hair follicles to produce hair.

Interesting findings have been thickening of hairs that have been growing but have miniturized (become thin). It will not cause hair to grow in areas of scarring or in areas where there was never hair. It’s also been found that new hair growth is sometimes pigmented in areas where hair had turned gray, representing a “youthful” follicle.

Recommendations are for at least one treatment yearly for females, and 2 for males. Topicals such as Rogaine or Propecia should be continued.

The process starts by drawing blood, 60-120cc. It is put in the Magellan processor to separate the PRP, which takes about 15 minutes per 60cc of blood. During this time, the scalp in numbed up with both topical creams as well as injections. When numb, the scalp in injected with the vitamin and mineral mixture as well as with the ACell solution. The PRP injection in then performed. The final process is using the Dermapen microneedling device to create very fine holes in the scalp. A by product of the Magellan PRP system is “PPP” which is platelet poor plasma. PPP has growth factors, but to a lesser degree than PRP. This solution is spread on top of the scalp and will be left there overnight. Washing the hair can be done the following morning. Sometimes extra PPP will be given to the patient to apply to the scalp at home. The total in office time is about an hour or an hour and 15 minutes. A second treatment (for men) is scheduled at 2-3 months.

Website: http://www.theclinique.net

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Facebook: https://www.facebook.com/TheAestheticClinique

Treating Post Inflammatory Hyperpigmentation (PIH)

For Restylane Silk…Size Matters…Smaller is Better

Fractional Coagulation is in, Bulk Heating is out for Radiofrequency (RF) Skin Tightening

All Botox Providers are NOT the same. Choose carefully!

Beauty and Skin Tips for those on a budget.

Slimming Ones Facial Appearance with Botox/Dysport

Recent Advances in Coolsculpting – 2014

Hyaluronidase – The “Magic Eraser” for Hyaluronic Acid (Juvederm, Restylane, Voluma) Dermal Fillers

Revance (RVNC) RT001 is Going to Improve Crows Feet and Sweating WITHOUT Needles

Hair and Eyebrow Restoration Completely NonSurgical using PRP and ACell

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