Question: I have a small, but noticeable, red vein on my cheek below my eye. I think this is what is called a broken capillary. I would love to have it removed, but I am a little concerned because of how close it is to my eye. Is it safe to treat this area and what sort of treatment would be used?
Answer: Yes, it is absolutely safe to treat these as long as the professional is well trained and well experienced with such issues. We obviously want to protect your eyes with laser-proof goggles, but as long as we can get to this spot on the skin with the goggles on, there really should not be any issue or concern regarding the safety of your eye. The treatment involves a laser that heats up the vessel and this in turn then allows the body to get rid of the vessel during the healing process. Frequently, we can get rid of these with a single treatment but, occasionally, these can be stubborn and require several treatments spaced weeks apart.
Question: I have begun to notice some ugly veins on my nose. Is this related to rosacea? What can I do to get rid of them?
Answer: It is quite common for veins to become visible beneath the skin especially along the crease between the side of the nose and the cheek and for most patients this has nothing to do with rosacea, but obviously if there are visible blood vessels in other areas of the face and cheeks, this very well could be the condition of rosacea but, again, the far majority of patients with strictly nasal veins do not have rosacea. Treatment involves heating these vessels with a laser. This damages the vessel lining and the vessel is then reabsorbed by the body and is visibly improved. This can take several treatments, but typically we can do an excellent job of getting rid of these unsightly vessels.
Question: I have heavy sun damage on the back of my neck and my shoulders. In the future, I will be more proactive about wearing sunscreen but what can be done to improve the look of my neck and back now?
Answer: We can treat the neck and back area with broadband light, which will target the abnormal pigmentation in these areas and help the neck and back look much better. This usually requires a few treatments, but we can use this broadband light in a rather intense way to greatly improve these areas with only a few treatments. Another option would be ProFractional laser treatments, which essentially lasers tiny, little holes in the skin and this healing process causes some new collagen deposition, which tightens the skin and can reduce apparent laxity or wrinkling in the skin. This can be safely performed in areas off the face, but I would highly recommend seeking out someone who has significant experience with this; otherwise, the new Ultherapy device, which uses microfocused ultrasound can also be used on the chest, neck, and back if we are trying to improve laxity in these tissues. A personal evaluation would be necessary to determine which treatment would be the most appropriate and in many of our clients, we perform combination treatments where we will combine broadband light, ProFractional laser resurfacing, and Ultherapy to give them the ultimate result.
Question: What facial rejuvenation treatments do you recommend to treat wrinkles stemming from years of smoking?
Answer: At Quintessa Aesthetic Center, we have a multitude of different options available for patients interested in wrinkle reduction. Some of these can be performed in the spa setting with minimal if any downtime. Others are much more aggressive and tend to be performed in an operating room and can give a patient nearly a week of significant downtime. With each treatment option there comes a cost and a degree of improvement. In other words, the deeper we treat the skin the more significant the improvement, and this usually is a technique that is going to be more costly and give patients more downtime. Ultimately, every patient’s face and finances and tolerance of downtime is different and we, therefore, highly customize the treatment so that the patient gets the results that they desire.
Question: What type of injectable filler is the longest lasting for filling out the wrinkles in the forehead? What, if any, complications are associated with injections of this particular filler?
Answer: Well, first of all, I typically do not recommend filling forehead wrinkles since, for the most part, these are dynamic wrinkles, which means that they are there due to overactive muscles, and I do not feel that filler injections tend to last all that long in these types of lines due to the activity of the muscle. I, therefore, typically recommend Botox to these areas as this will dramatically improve forehead lines and though it is a temporary solution, is extremely safe and effective. For patients that insist on a filler, I would first insist that they get Botox and should there be any significantly deep lines afterwards, we could consider filling these areas, but I would not recommend any sort of long-term filler for fear of complications in this area. I would, however, be willing to use a hyaluronic acid filler such as Restylane or Juvederm since these can be reversed should there be any concern about the viability of the skin. In other words, in some areas of the forehead or especially between the eyebrows, if the filler is placed in the skin underneath these wrinkles, it can cause so much congestion to the blood vessels that it prevents oxygenation of the tissue, which can lead to damage to the skin and resulting scarring. This could potentially be reversed if the filler was hyaluronic acid but can really not be reversed if the filler is a longer lasting filler such as a calcium-based filler.
Question: I would like to get injectable fillers in my face. I would like to plump both my lips and my nasolabial folds, which have gotten quite pronounced. I would like hyaluronic acid because the reports that I read indicate it is longer lasting than collagen. Is hyaluronic acid appropriate for both areas?
Answer: Yes, hyaluronic acid is an excellent filler for both your lips and your nasolabial folds, and though it typically does not last as long in the lips as it does in the smile lines, it is still a very long lasting option and overall it is extremely safe and effective.