Injectables - Which for What?

With so many injectable options, it can be difficult to narrow down which would be best to address your concerns. There's plenty out there to get lots of unbiased information about, but here are three, very effective and versatile fillers our doctors like to use:

Botox® Cosmetic is ideal for treatment of moderate to severe frown lines between brows, but can also be used for crow's feet, and some brow lifting. Think of the region from the eyes on up, however others, like fine "bunny lines" around the nose and mouth, could benefit from this as well. It's important to understand that it can't "fill" any wrinkles, rather it inhibits chemical responses that trigger muscle movement. This relaxation of facial movements stops (and in some cases allows the reversal!) of skin creasing. Expect results to last between 3-5 months.

Radiesse® is a dermal filler injected into deeper wrinkles such as naso-labial folds (laugh lines from nose to mouth), but also, when administered with an artistic eye, is used for cheek enhancement, and recontouring of the chin and jaw as well. This thicker gel solution contain microspheres of calcium hydroxylapatite, a naturally occurring substance in the body, which not only plump the skin, but also encourage a significant amount of new collagen production. Results are proven to be some of the longest-lasting among all dermal fillers. Most patients report their Radiesse results lasting past the expected 1 year mark!

Juvederm® is a hyaluronic acid gel (mimics one of your own natural skin structures), and used to fill and smooth finer to moderate creases when injected into the mid dermis. This is ideal for minimal irregularities such as fine lines around the mouth, nose, eyes, and forehead. Expect results for up to one year.

The filler recommended for you will depend on your desired results for the area of concern, where the doctor plans to inject the product, and the thickness of your skin. To ensure that you choose a dermal injectable that is not only safe, but will also help you achieve your cosmetic goals, it's best to consult with a trained and professional provider. And remember, all of our skin consultations are complimentary!

Out Dam*%@ Spot!

A mottled complexion can be one of the first signs of aging, a manifestation of years of "skin abuse," whether extrinsic—sun exposure, smoking, diet, acne scarring—or intrinsic causes determined by your genes and hormones. Whatever the cause, take heart that there is something you can do about them. There are hundreds of products and procedures available now to you, but your approach must be customized to your skin type & needs, and all require time, patience, diligence.

It's easiest to think of all your options falling into just 3 categories, with broad descriptions of your many options following each one:

1. Exfoliation: mechanical or chemical removal of dead skin cells. This removes superficial epidermal pigmentation and pore blocking debris, reveals a more youthful cast to the skin surface, allows better penetration fo rejuvenating topical agents, and produces mild irritation of the dermis to induce new collagen deposition in the superficial dermis (that's a good thing!)
Your Options: products with any type of scrubbing "beads;" hydroxy acids (AHA or BHA such as glycolic, lactic, or salicylic); any number of in-office peel procedures using chemical solutions, (micro)dermabrasion, or lasers for deeper peels and more significant results.

2. Stimulate New Collagen Formation/Regulate New Skin Cell Production: loss of dermal collagen is a major factor in aging. So dermal thickening in this sense reduces depth & number of wrinkles, and provides nutritional support for the overlying epidermis, making it appear healthier, fresher, and more elastic (with 'snap' instead of crêpe-like 'sag.'). Because many prescription products & services that stimulate collagen formation also have a similar action on new skin cell production, we often lump them together. This normalization of skin cell production ensures normal functioning (including coloration) of skin cells, and can be a powerful ally in the battle against sun-damaged and aged skin.
Your Options: prescription retinoids (commerical names like Retin-A, Renova, Tazorac, Differin); over the counter retinols; non-ablative lasers/lights to heat & stimulate dermal tissue (like Aramis, IPL, or radiofrequency); ablative lasers that aggressively exfoliate to the point of inducing collagen rebuilding in the dermis.

3. Remove Abnormal Pigment and Blood Vessels: wait, you're probably thinking, "isn't this the whole point of the article, and why is this listed last?" This last step can only be effective and successful after first addressing the previous issues. Lightening excess pigment can be done very gradually with melanin suppressing topical products, or significantly accelerated through the synergistic effect of these topicals with laser/light therapy.
Your Options: Topicals with active ingredients such as hydroquinone 2%-4% (non-prescription is available only up to 2%); arbutin; kojic acid; azeleic acid; vitamin C; licorice extract.
In office procedures (this list will look very familiar): exfoliating peels, IPL which is absorbed into and destroys excess brown and red pigment; ablative lasers to physically remove superficially discolored layer of skin cells.

Generally, the deeper and more instant the procedure, the greater the risk of injury and post inflammatory hyper- or hypopigmentation, so discuss your options at length with your skin care provider.

And the most guaranteed, inexpensive, and surefire way to avoid this 1st sign of aging and prevent it from worsening? Full-spectrum UV sunscreen and minimizing excess sun exposure.
If you're lucky enough to have minimal aging changes so far, starting these preliminary steps early is the best way to avoid the expensive and labor-intensive effort required to resolve these pigmentation issues when they get intensify.


References:
Begoun, Paula. http://www.cosmeticscop.com/skin-care-facts-skin-lightening-brown-ashen-pigmentation-freckling-discoloration.aspx.
Kunin, Audry, M.D. The DermaDoctor Skinstruction Manual, 2005. Simon & Schuster, NY.
Seckel, Brooke, M.D. Save Your Face, 2nd Ed, 2006. Peach Publications, Concord, MA.

Zerona™ Laser + AWT for Cellulite

JuvenescenceMD is among the first in the state to offer Zerona, a low-level, painless laser designed to remove fat and contour the body without invasive surgery. Lose several inches in the course of two weeks!

Just in time to get toned up, slimmed down, and gorgeous for those big upcoming summer events. Even for you Juve members who do not live in the Tacoma area, this will be well worth the drive. Check out our Facebook link for an overview of the process.

Our "Zerona Night" on July 9th was a success, thanks to you. To show our appreciation,we are offering
$300 off Acoustic Wave Therapy cellulite treatment per body region, and
$200 gift certificate for personal training and a 2-week membership at the exclusive "Club at Gig Harbor" gym
with any Zerona™ Laser treatment purchased in August.

The Twins Are Finally Here!

Many of you have been asking about them, so here they are, the newest additions to the JuvenescenceMD family.
Welcome babies Althea and Svea!

Micropeels & Aramis Laser - Progressive Skin Care

Our Micropeels are a safe, non-invasive method of skin resurfacing and rejuvenating skin. This procedure typically begins with microdermabrasion, where a gentle spray of crystals & simultaneous suction removes dulling surface skin cells. A medical grade peel is then administered, thus promoting skin regeneration while revealing healthy, dewy, new skin. The chemical peel is customized to your skin's needs and tolerance, and we have a variety of alpha and beta hydroxy acids at varying strengths available.

Some of our specialty peels may not incorporate microdermabrasion because of their aggressive or unique nature. The deeper peels we offer include the Vitalize Peel and the Orange Peel (TCA). We also offer an organic fruit enzyme resurfacing treatment—“Organic Passion Peptide Peel”— for sensitive clients seeking a natural, gentle, yet effective approach to resurfacing and skin renewal.

We quite often combine MicroPeels with the Aramis laser for exceptional results. To treat unwanted facial lines and wrinkles via dermal remodeling of collagen, an “anti-aging” setting heats the dermis while protecting the epidermis, thus building and stimulate the natural formation of new collagen. The technique is painless, and the resultant thickening of the dermis enhances skin radiance and elasticity.

The Aramis laser's "anti-acne" setting treats acne where it begins, using a patented wavelength to penetrate the skin’s layers to the depth where sebaceous glands are located. The laser thermally alters the reactors in the sebaceous gland, reducing oil and bacteria production, thereby reducing skin oiliness and the number of resulting acne lesions. Results are gradual with an approximate 15-20% reduction in the number of lesions after each treatment.

Four laser treatments at either setting produce amazing results.

In addition to the Aramis laser, you can combine MicroPeels with other skin rejuvenation programs such as our IPL photo-rejuvenation and/or injectibles to create a synergistic program.

Popular Packages:
Skin Sense. 6 Micropeels – selected peels customized to your needs
Inner You. 4 Micropeels, 4 IPL treatments
Perfect You. 4 Micropeels, 4 IPL treatments, 4 Aramis laser treatments
Rejuvenate and Smooth. 4 Micropeels, 4 Aramis laser treatments
Acne Clear. 6 Micropeels, 4 Aramis laser treatments

CO2 Laser Resurfacing

I am interested in learning more about the CO2 laser [Dermal Optical Thermolysis] - what type of results can I expect from this treatment? What is the estimated down time? Is this a series of treatments? --L.T.


Dr. Jennifer Younggren: I am glad that you asked! The CO2 laser is an ablative laser that resurfaces the skin. It can be used on the face, neck, chest, hands - anywhere a client desires an improvement of skin texture and tone.

This technology has been used for years, but there was a significant drawback that kept folks from trying it - downtime. The newer technology uses a fractional approach - treating only a percentage of the skin over the entire face. This is done with the 'dots', or very small areas of treatment with the laser, evenly spaced over the treatment area. This results in much less thermal injury to the skin, and much less down time. In fact, social down time for this procedure is usually only 2-4 days - a weekend for most folks!

We are using this treatment to treat skin texture and combat signs of aging. It really helps with fine lines and wrinkles, which can be hard to treat with any of our other modalities. This is also an effective treatment for acne scarring - another difficult to treat issue. There has been success as well with using the CO2 fractional for refractory redness and age spots, although the IPL will still be the first line of treatment for these skin issues.

Most clients will receive the most benefit from two treatments, performed 4-6 weeks apart. If you are just wanting a general tightening and 'freshening up' of the skin, then one treatment will suffice, but for most folks (and definitely for acne scar clients) two will be the recommended protocol.

When you show up for your treatment, your face will be cleansed. If you have purchased a 'platinum package' you will then have a microdermabrasion to remove dead skin cells prior to treatment. If not, we will use the Clarisonic for this purpose. We will then apply a layer of topical numbing cream to enhance your comfort, and you will relax for 20-30 minutes. Then, we will will perform the procedure, which will take 15-20 minutes to complete. We will then apply a soothing post treatment balm, and you will be able to go home.

Sun avoidance is required for 72 hours post procedure. During this time you can cleanse your skin with sensitive skin cleanser (this is provided with the platinum package, and purchased separately otherwise), and moisturize and protect with the post procedure balm that we will provide for you. On day 3, mineral makeup can be used, and pinkness will have receded to the point that most clients will feel socially comfortable. By day four you can transition to sensitive cleanser, ceramide cream (also required), and sunblock, and be out and about in the world with very minimal pinkness!

Of course, every client is different, but I wanted to try to summarize the experience for you so that you will know what to expect if you decide to proceed. You would then return for your second treatment in 4-6 weeks.

We are so excited and pleased to finally be able to offer an ablative treatment to our clients, and yet have it be advanced enough that they will not have the weeks of social down time of past technology.

Brad and I will be in the office offering this treatment on May 14-15 and May 20-22. Feel free to call Juve at (253) 472-0507 Wed-Sat to make your appointment or if you have any questions.

April SpotLight - Thank You!

A big thank you to everyone who came to support our very first Spotlight Event, where we hosted a party featuring local women entrepreneurs and their businesses. We had a great time with Priya and her Jewelwraps scarves and jewelry collection, as well as Nicole's PartyLite pieces. A special thank you, too, to Kazuko for the beautiful photographs of the event (click image above).

2-Year Anniversary Party Thank You!

...A quick and heartfelt THANK YOU to everyone who came out and made our 2nd year anniversary celebration such a joyful and successful event!

Keep an eye on the Facebook group [and this blog] for the most up to date specials and Juve happenings.

SkinMedica in the News This Month

Acne and Diet Link?

We highly recommend these fantastic books for those struggling with adult or teenage acne, as well as for those frustrated in general with their skin. The Clear Skin Diet by Alan Logan & Dr. Valorie Treloar--not restrictive in nature, rather an advocate of a wholesome diet conducive to healthy skin--stresses the benefits of foods minimizing systemic inflammation and promoting faster healing. It takes a more critical look at studies purporting no link between diet and skin health, and makes a compelling argument for the collateral benefits skin may enjoy when addressing internal issues in conjunction with good skin care.

Breaking Out by Lydia Preston provides one of the most concise yet thorough discussions on the subject of adult and teenage acne you'll find on the market. Promoting gentle skin care while de-mystifying the multitude of amazingly effective acne treatments available today, this book was the source of many "ah ha!" moments even for those of us involved in the skin industry for a while. This source minimizes the role of diet for the skin and focuses on what can be done to the skin.

Bottom line, most studies "disproving" the link between diet and skin only failed to prove a direct link between the two. In the face of helplessness that acne often wreaks upon us, it's empowering to take steps toward quality nutrition, a healthy intestinal tract, restful sleep, management of negative stress, and physical activity, in an often successful and therapeutic effort to dampen the acne process.

Having a good understanding of the origins of different types of acne, how different bodies react to create acne, what makes it flourish, and how different treatments affect different aspects of it, can only help in making the best skin care and dietary decisions for you.
Feel free to contact us to for a complimentary skin consultation--we'd be happy to answer questions and suggest a customized treatment.

Not-So-Matte Minerals - Getting Dewy for Spring!

We love the coverage and like-skin feel of mineral makeup, but let's face it, you can't avoid looking "made up" with it, especially during the day. To switch up your look for warmer weather, we recommend liquid minerals, or if you want to just jazz up the minerals you currently have, use a specialized misting spray to finish your look. Look for one that drenches the skin in humectants, healthy skin cell-mimicking ingredients, and age-fighting antioxidants. Here are two of our favorites below:

TRUE™ Transforming Skin-Tint: Prepare for a little magic with this liquid foundation. Stressed skin instantly transforms back to a youthful, even-toned complexion, while age defying benefits protect. Visibly firm and smooth skin appears from an elixir of luxe minerals and essential vitamins. In 6 shades leaving skin aglow in sheer to undetectable coverage. Wear alone or prime under mineral foundation for added benefits. Paraben-free. Ideal for normal to dry skin. $46 How to Apply: Pat and smooth on liquid foundation using the new Being TRUE™ foundation brush. Wear alone or set with Protective Mineral Foundation SPF 17. TRUE™ Transforming Mineral Mist: This is the necessary finishing step to transform Protective Mineral Foundation into the ideal finish, making it instantly one with skin. Colloidal gold and silver, plus the Being TRUE™ Antioxidant Complex bathe skin in anti-aging benefits. This beneficial spray is alive with the Being TRUE Signature Aroma, turning daily stress into positive purpose. Equally powerful alone, used night, day and absolutely in-flight. $14

How to Apply: Spray generously 3 to 4 times over mineral foundation to set and create a seamless application. Spray generously over skin to re-hydrate any time throughout the day, or to finish facial treatment.

It's finally here! Dermal Optical Thermolysis is a CO2 fractional laser used to minimize wrinkles, reduce facial scars, improve skin firmness and more. Using microscopic laser dots that laser both the surface as well as deeper layers of the skin, your procedure would take less than 1 hour with minimal downtime (typically one weekend) for drastically improved, younger looking skin. Available for a limited time only, and offering a introductory special to clients. Call today for your appointment: See DOT LIVE and in the news!

You can now purchase SkinMedica directly using JuvenescenceMD as your designated physicians.

Picture Yourself
with Botox® Cosmetic & Juvederm®
Visualizer Tools

Smooth Your Lines Virtually!

Curious about how you'd look if your frown lines and wrinkles were softened or completely smoothed? Click both images above for the Juvéderm® and Botox® Cosmetic visualizers to see a more beautiful you with the natural look you want.