Question: What is CO2 laser resurfacing? Is all laser resurfacing CO2?
Answer: A CO2 laser is one type of laser that can be used in esthetic medicine. There are many other types of lasers that can be used depending on what problem we are trying to treat, including the erbium laser for ablative skin resurfacing, but there are many other lasers, including the diode laser, pulsed dye laser, copper vapor laser, KTP laser, argon laser, and YAG laser and many others. A CO2 laser targets water and when the laser is fired at the skin it literally vaporizes the skin to a specific depth depending on what settings are used on the laser. An erbium laser is much more efficient at vaporizing the skin and you get much less heat transfer into the deeper skin which then creates less redness after a laser treatment. Ultimately, if you are interested in a laser treatment I would recommend seeing someone with extensive experience with a variety of different lasers so that they can customize your treatment approach for your specific problem.
Question: Is there one laser hair removal machine that is the best?
Answer: I would say there is a couple of machines that would be considered the best and certainly this is an arguable subject, but in my opinion the diode laser is one of the best hair removal systems and the Duette system by Vasculight has a very large head with a vacuum assist to it that creates a nearly pain-free hair removal treatment that is extremely fast and effective and at this point in time that would be my personal favorite hair removal system and the one that we employ at Quintessa Medical Spa.
Question: Are there any fillers that can fix a downturned smile?
Answer: Yes, virtually any of the fillers can be placed below the downturned smile at the upper part of what would be considered a marionette line to improve the appearance of a downturned smile. We can also treat the depressor anguli oris muscle with a small amount of Botox to relax that muscle as this is the muscle that tends to pull the corner of the mouth downward and when we relax it the corner of the mouth will lift slightly, getting rid of that undesirable appearance.
Question: Is there any one filler that can be used to improve marionette lines and lip lines as well as some other superficial facial wrinkles, or is it better to use different fillers for different problems?
Answer: I usually go ahead and just use a single filler in most circumstances, unless the patient is going to be requiring multiple different syringes of filler and then I may combine different fillers for maximizing their effect. In other words, if you need a filler that is relatively thin and can be placed in small lines and wrinkles and you have enough problem areas to require a full syringe for this, but you also would like marionette lines or nasolabial folds filled, I may combine Juvederm Ultra and Juvederm Ultra Plus or Restylane and Perlane to provide the maximum longevity and effectiveness for your particular concern.
Question: I will be getting large areas treated with laser hair removal. Is there any preparation of the skin for this?
Answer: The only preparation that is necessary is to avoid significant sun exposure so that you do not have any abnormal pigmentation in the skin. This will allow the provider to use the maximum amount of energy for your particular skin type and this should maximize your hair removal results.
Question: What are the different options available for chemical peels?
Answer: The different options for chemical peels are nearly endless due to the fact that there are so many different chemicals and substances that we can apply to the skin and cause some sort of a peel. Ultimately the decision needs to be made as to what we are trying to improve upon regarding the patient’s skin before we decide what type of a chemical peel would be best for that particular problem. Frequently we can perform broadband light treatments to help patients with their pigmentary and vascular abnormalities and this requires absolutely no downtime. Other times, patients have extremely deep wrinkles and they really desire significant rejuvenation to the skin and this would require an extremely deep chemical peel or an extremely deep laser peel for an adequate visible improvement. Ultimately, this is a highly customized area of facial plastic surgery and I would recommend that you seek out a board-certified facial plastic surgeon who is very comfortable dealing with virtually all aspects of skin rejuvenation.
Question: I am terrified of needles, but I still want to pursue Botox injections. I think that is the best way to treat my frown lines, from what I have read online. Do the injections hurt? If so, is there any topical anesthetic that you can give me so that they do not?
Answer: For the most part when Botox injections are administered by a highly skilled professional they are nearly painless and I therefore do not give any sort of topical anesthetic when I do Botox injections on my patients. You can; however, ice the area or even apply a topical anesthetic prior to the Botox injections which can make them even more comfortable.
Question: I would like laser hair removal done on both my arms. How many sessions do you think this would take?
Answer: Laser hair removal for most areas of the body are going to take 6 to 8 treatments for adequate hair reduction. In younger patients, such as teenagers, this can be more of a life-long treatment where we perform 6 to 8 treatments, but they may need a touchup treatment every 6 to 12 months for adequate relief. We certainly never promise that all the hair in this area will be gone forever, but overall laser hair removal is extremely successful at reducing the number of hairs as well as the thickness and darkness of the hairs.
Question: What percent improvement can I expect in the wrinkles around my nose and mouth after my first treatment of Radiesse?
Answer: Depending on how deep your folds are you can expect nearly 100% improvement in the folds as long as an appropriate amount of the filler material is used. Essentially, what we always want to try to provide is what we call complete correction for patients regarding injectable fillers. That means we want to get rid of as much of the depression or fold or line as possible since visually if we only improve it by 50% that is certainly not going to be horribly appreciated by the patient, but if we can completely get rid of the fold or line that is obviously visually quite distinct and will please the patient.
Question: Will I need to stay out of the sun after my chemical peel treatment?
Answer: Immediately after a chemical peel or any sort of laser resurfacing you will need to avoid the sun until the skin has healed, but once healing has occurred you can go outside and resume normal activities as long as you wear sun protection which is the consistent use of a sun block. I also recommend that if possible that you wear a large brimmed hat and sunglasses as well to avoid any UV radiation exposure. Most of our patients understand that the sun exposure is the reason that they have a significant amount of aging features to their skin and therefore understand that after a chemical peel or laser peel that they are going to want to limit the sun exposure in the future. It does not; however, mean that you cannot continue to enjoy outdoor activities, you just need to be very careful about protecting the skin.