Women and men who wish to improve the health and appearance of their skin have many excellent options today. For most people, the unwanted facial changes that give rise to “aging” are due to muscle imbalance and loss of volume support. In many individuals, previous sun exposure, injuries, and skin conditions have caused scarring, textural changes, skin thinning, and discoloration.
Our board-certified cosmetic dermatologists, Drs. Julie Salmon, Miriam Cummings, Shannon Heck, and Jennifer Sawaya, are experts at in-office procedures, such as laser, botulinum toxin, and soft-tissue filler treatments, which can effectively balance form and function and improve skin quality. If the fabric of your skin is damaged, discolored, or wrinkled, our dermatologists can tailor a program specific to your needs. Their goal is to create intelligent beauty: an enhanced, more vibrant appearance that optimizes health and does not look “treated.”
*(For safety purposes, we offer the products in the list above only to our patients.)
Our dermatologists have been providing safe and effective non-surgical and minimally-invasive procedures for skin rejuvenation long before the surge in popularity of botulinum toxin, soft tissue fillers, and lasers for aesthetic purposes. They attended the first conference in the world on the cosmetic use of Botox® and were among the first to use hyaluronic acid fillers, such as Restylane®, Juvéderm®, and Voluma™. Our dermatologists traveled to evaluate the first Fraxel® laser prototype prior to its eventual launch. Our cosmetic dermatologists stay current, regularly exchanging ideas with other leaders, and investigating innovations in the rapidly-changing field of aesthetic medicine.
Our dermatologists explore the wide spectrum of new treatments but select only those that they deem highly safe and effective. By thoroughly researching new procedures and products with a critical eye, our physicians make informed choices to optimize patient care. Our patients’ best interests always come first.
With exceptional technical expertise and experience, as well as a reputation honed over many years as dedicated and caring physicians, our cosmetic dermatologists now serve a devoted international clientele. Each treatment is individualized and each patient is given the attention that he or she requires and deserves. If you are interested in discussing ways in which you could optimize the health and appearance of your skin, schedule a cosmetic consultation at either our Phoenix or Scottsdale office.
Manufactured by Cutera®, the CoolGlide® laser is a versatile Nd:YAG laser system that can be used to treat pigmented and vascular lesions and improve the appearance of wrinkles, scarring, redness and more.
Many men and women develop unsightly and sometimes painful veins on the face and/or legs, which can significantly affect their quality of life both physically and emotionally. CoolGlide Vein Therapy can painlessly and effectively remove these veins through a series of treatment sessions that deliver pulses of light energy to the affected area(s).
Treatment with the CoolGlide laser system is considered safe for most patients with only a minimal risk of complications. Side effects such as redness, swelling, and mild bruising are considered common and usually, go away on their own within a few days. Your doctor will discuss the safety of the CoolGlide procedure with you before your treatment.
The Fraxel® Restore is an FDA-approved, non-ablative laser system that is used to rejuvenate the appearance and texture of the skin on the face, neck, chest, hands, or arms. The Fraxel Restore laser treats a wide variety of skin conditions, including fine lines, wrinkles, melasma, brown spots, age spots, enlarged pores, and acne scarring.
The Fraxel Restore laser utilizes a technology known as fractional resurfacing. Fractional resurfacing breaks down and separates beams of light in order to deliver this energy only to targeted, highly specific areas of the skin’s surface. The surrounding undamaged skin is preserved between the laser treatment sites, which results in rapid healing following the procedure. Treatment with Fraxel Restore is safe and effective for patients of all skin types and textures.
Fraxel Restore laser treatment sessions usually last about 30 minutes, and do not require the use of pain medication. There is little downtime needed for recovery, with most patients resuming activities in 1 to 3 days. Optimum results are generally achieved after 4 or 5 treatments, performed in intervals of 3 to 4 weeks. Following treatment, patients often notice a significant improvement in their skin’s appearance.
The Palomar Icon™ Aesthetic System is an advanced, light-based form of treatment designed to alleviate a variety of skin conditions. It offers concentrated laser power with a built-in calibration feature to optimize the treatment of a targeted area. This versatile device provides a safe, effective solution for dealing with a wide range of surface and subsurface skin problems.
The Palomar Icon system features patented state-of-the-art technology to provide patients with the most comfortable experience as well as the most successful results. It uses the Skintel® Melanin Reader, which is the only melanin reader that has received FDA clearance. This device measures the average melanin density in the skin before the treatment begins in order to tailor treatment settings to that patient’s unique skin characteristics.
Varilite is an advanced laser system used to treat the appearance of vascular, pigmented, and cutaneous lesions on the face and other areas of the body. Lesions on the skin are destroyed with precisely delivered heat energy while surrounding healthy cells are left intact.
This treatment takes less than an hour to perform, although the actual length may vary depending on the area being treated. No anesthesia is needed, and most patients achieve their desired results in just one to three visits.
The Varilite laser is effective in eliminating or reducing the appearance of vascular lesions, blood vessels, or other types of pigmentation on the skin. With minimal discomfort and no downtime, most patients are more than satisfied with the results of this procedure.
Varilite laser treatment is safe for most patients and can be used on nearly any skin type. After treatment, patients may experience mild redness, swelling, and flaking. These side effects usually go away on their own within two weeks and can be covered with makeup if patients desire.
Botox® Cosmetic is a prescription drug that, when injected, temporarily paralyzes muscles. It contains a purified and safe form of botulinum toxin A, which is produced by the microbe that causes botulism. Manufactured by Allergan, Inc., it is used to treat permanent furrows and deep wrinkles in the skin that are formed by the continual contraction of facial muscles. In addition to its cosmetic applications, it is used to treat a number of medical problems, including excessive sweating, overactive bladder, neck spasms, crossed eyes, chronic back, and jaw pain, and migraines.
Although originally approved by the U.S. Food and Drug Administration for the treatment of eye and muscle spasms, Botox Cosmetic was quickly recognized for its cosmetic value. Properly placed injections of Botox Cosmetic block nerve impulses sent to muscles, weakening them to the point where they cannot contract, and temporarily eliminating moderately severe furrows and lines. Botox Cosmetic is used to treat the following:
According to Allergan, Botox Cosmetic has been “extensively researched, with approximately 2500 studies.”
Using a very fine needle, Botox Cosmetic is injected directly into facial muscles that are causing furrows and lines. Receiving the injections requires no anesthetic, but some doctors choose to numb the area to be injected with ice packs or topical anesthetic cream. Results can usually be seen within a few days of treatment, and typically last up to four months, although areas that are treated on a regular basis may retain results longer. Injections should be given only by qualified medical professionals.
Injection-site Botox side effects are usually mild and temporary, and include the following:
Normal activities may be resumed immediately after receiving injections.
Hyperhidrosis is a common condition that involves excessive sweating of certain parts of the body, including the face, hands, feet, and underarms. Those with this condition often need prescription-strength antiperspirants to control sweating and may have to change clothes frequently or avoid wearing certain fabrics.
Hyperhidrosis can be treated with Botox® Cosmetic injections, which block the nerves that stimulate the sweat glands, significantly reducing the amount of sweat produced. Most patients notice a significant reduction in underarm sweating in 4 weeks, with results lasting for more than 6 months. Although symptoms gradually return, results can be maintained with routine follow-up treatments.
Chemical peels remove damaged outer layers of skin to make skin smoother, reduce scarring and remove blemishes. Ranging from mild to strong, there are three types of chemical peels: alpha hydroxy acid (AHA), trichloroacetic acid (TCA) and phenol. The strength of each peel is tailored to the patient. Peels can be combined with other procedures, such as facelifts, for additional improvement to skin. Chemical peels may be covered by insurance if they are performed for medical rather than cosmetic reasons.
Chemical peels are performed in a plastic surgeon’s or dermatologist’s office, or an outpatient surgical center. Anesthesia is not required because TCA and phenol have anesthetic properties, and AHA produces only a slight stinging.
During a TCA or phenol peel, the skin is cleansed and the solution is applied, which may cause a brief stinging sensation. Petroleum jelly or a waterproof adhesive tape may be put on the skin following a phenol peel. During an AHA peel, the skin is cleansed and the solution applied; there is no need for post-peel ointment or covering.
A phenol or TCA peel can result in tingling or throbbing, reddened skin, a crust or scab, and significant swelling that lasts depending on the strength of the peel used, about a week. With a phenol peel, eyes may be swollen shut at first, and the patient may be put on a liquid diet and advised to keep talking to a minimum. Any tape used is removed after a day or two. AHA peels can cause temporary stinging, redness, and irritation, as well as flaking or crusting. After a chemical peel, it is essential that the skin is protected from the sun.
Prescription Dysport® injectable is a U.S. Food and Drug Administration-approved treatment for temporarily lessening or eliminating moderate-to-severe frown lines between the eyebrows. Like Botox® Cosmetic, Dysport injectable is placed directly into the muscle underneath a furrow, weakening the muscle to the point where it cannot contract.
Dysport, also known as Reloxin, is made from a neurotoxin produced by the bacterium Clostridium botulinum; it is the same neurotoxin used in Botox Cosmetic.
Medically, Dysport injectable is used to treat excessive underarm sweating; symptoms of cervical dystonia, which include neck pain and abnormal head position; and muscle spasms. Cosmetically, Dysport injections are used to treat the following:
Using a very fine needle, Dysport injectable is placed directly into facial muscles that are causing furrows and lines. No anesthetic is required, but some doctors choose to numb the area to be injected with ice packs or topical anesthetic cream. Results can usually be seen within a few days of treatment, and typically last up to 4 months, although areas that are treated on a regular basis may retain results longer. Injections should be given only by qualified medical professionals.
According to the manufacturer’s website, candidates for Dysport injectable are “adults less than 65 years of age” who want “temporary improvement in the look of moderate-to-severe frown lines between the eyebrows (glabellar lines).” It may not be suitable for those with the following:
Anyone who is pregnant or breastfeeding, or has a neuromuscular disease, should not receive Dysport injectable.
Although made from the same bacterium, there is anecdotal evidence that Dysport injectable may last longer, spread farther and take effect more quickly than Botox Cosmetic.
Side effects of Dysport injectable are usually mild and temporary, and normal activities may be resumed immediately after receiving injections. Injection-site side effects include the following:
Eyelids can droop when Dysport injections are made in the glabellar region; they usually return to normal within 3 weeks. Side effects of Dysport injectable are the same as those of Botox Cosmetic.
Belotero Balance is the latest, most advanced form of dermal filler available today. It has a unique ability to integrate with the tissues of the skin, providing volume and a more youthful shape to the face. FDA-approved to treat moderate to severe wrinkles and folds, Belotero Balance can reduce lines and other signs of aging while enhancing facial structure and contours.
This treatment achieves smoother skin and very natural-looking results. Belotero Balance is gentle enough to treat the delicate skin around the lips but it can also be very effective for treating deep furrows such as the smile lines of the nasolabial folds.
The active ingredient in Belotero Balance is hyaluronic acid, or HA, a naturally-occurring substance within the skin. The HA binds to water, plumping the skin tissues, and filling in wrinkles and lines around the treatment site.
Belotero Balance dermal filler can help restore a more youthful, well-rested appearance to the face. It is particularly effective in treating certain areas of the face, including:
Adults of any age who are concerned about facial lines or wrinkles may be good candidates for treatment with Belotero Balance. These are often problems that become more significant as people get older, but even younger men and women may experience common signs of aging due to sun exposure, heredity, or other factors. It is also important for a patient’s expectations to be realistic about what the treatment can achieve.
Belotero Balance has a thinner, more lightweight composition than many other dermal fillers. This helps the gel that is injected to be distributed much more evenly and provides a smooth transition between the treatment area and the surrounding skin. It does not form lumps as some alternative forms of dermal filler occasionally do. Another benefit is that Belotero Balance may be injected close to the surface of the skin to maximize its effects. When other HA fillers are injected near the surface, they can produce a blue tint in the skin at the treatment site.
The quick and nearly painless procedure typically takes approximately 20 minutes. Using a fine gauge needle, the Belotero Balance gel is injected into the skin at the treatment site. The results of a Belotero Balance treatment will be visible immediately. However, the corrections achieved by the filler injection are not permanent and vary by individual. For many patients, the effects are still apparent nine months after an injection. To best maintain the results, follow-up treatment sessions are typically recommended every six to 12 months.
There is no downtime needed after an injection with Belotero Balance. Most people can return to work or other normal activities immediately after the treatment session.
While considered a safe form of treatment, injectable dermal fillers may be associated with certain side effects. The most commonly occurring side effects after Belotero Balance treatment tend to be redness, irritation, swelling, itchiness, bruising, or tenderness around the area of the injection. These reactions are typically mild and short-lived if they arise, usually improving on their own within a few days. However, if they do not resolve, patients should contact their doctor.
Juvéderm® Ultra and Ultra Plus injectable gels are U.S. Food and Drug Administration-approved dermal fillers that, according to their manufacturer, Allergan, Inc., are designed to “temporarily treat moderate to severe facial wrinkles and folds such as nasolabial folds” in people older than 21. JUVÉDERM Ultra is used on moderate wrinkles and folds, whereas the thicker Ultra Plus is used on deeper ones.
Juvéderm Ultra and Ultra Plus are smooth-consistency gels that restore volume to the skin and lessen the appearance of wrinkles and folds. They are made of hyaluronic acid (HA), a sugar that occurs naturally in the body. In terms of the skin, HA’s role is to deliver nutrients and hydration and act as a cushioning agent. Young, healthy skin contains a lot of HA, but factors that include aging and sun exposure reduce the amount, causing the skin to lose structure and volume. JUVÉDERM injectable gels are most effective at improving the appearance of nasolabial folds, the lines that run from the bottom of the nose to the corner of the mouth on both sides of the face.
Juvéderm Ultra and Ultra Plus injections take about 15 minutes to administer in a doctor’s office. A fine needle is used for each injection, which is given under the skin in the targeted area to add volume or fill in wrinkles and folds. Because Juvéderm injectable gels do not contain lidocaine, a topical anesthetic may be used to minimize discomfort. Afterword, the doctor may gently massage the treated area(s).
Once treatment is completed, patients can return, with virtually no downtime, to their regular activities. For the first 24 hours after treatment, to reduce the risk of complications, patients should avoid strenuous exercise, excessive sun or heat exposure, and alcohol consumption.
The results of JUVÉDERM Ultra and Ultra Plus are visible immediately after injection; any swelling and bruising, to which ice can be applied, should subside during the next few days. Results can last 6 to 9 months, and, in some cases, up to a year. However, according to its manufacturer, “Results from injectable dermal filler vary and correction is temporary. Supplemental ‘touch up’ treatments may be required to achieve and maintain optimal correction of . . . wrinkles and folds.”
Although Juvéderm Ultra and Ultra Plus are considered safe, there is a risk of side effects. They are usually limited to the injection site, and include the following:
Juvéderm injectables are the first HA fillers that are FDA-approved for use on people of color.
There are also Juvéderm formulas that contain lidocaine to reduce any discomfort from the injections: Juvéderm Ultra XC and Juvéderm Ultra Plus XC.
Juvéderm Voluma™ is a new, FDA-approved dermal filler formulated specifically to add volume to the face around the cheeks and chin. This is the only injectable gel created to provide a subtle, natural enhancement to the mid-face, addressing changes in definition that occur over time. Juvéderm Voluma can help restore more youthful contours by plumping up the area that so often loses volume as part of the aging process. It can also return a firmer shape to the jawline when some softening has set in.
Juvéderm Voluma is not only an effective treatment method, but it is long-lasting as well. In many patients, the results will last for a period of up to 18 months.
The active ingredient in Juvéderm Voluma is hyaluronic acid (HA), which is a substance naturally produced within the skin. As we get older, the levels of HA present in the skin begin to decline, resulting in a loss of volume and sunken or sagging cheeks. Juvéderm Voluma integrates into the existing collagen and elastin in the skin tissue to offer greater support and elasticity. This can provide a noticeable smoothing and firming to the skin and lend the facial structure a more substantial definition.
Juvéderm Voluma is the latest in the Juvéderm line of dermal fillers. These various formulas have a successful history of reducing the appearance of wrinkles and folds in the skin and rejuvenating the face.
Adults of any age who notice changes to their mid-face or at the chin or jawline may be considered good candidates for treatment with Juvéderm Voluma. Typical early signs of aging may include a visible decrease in volume, a sagging of the cheeks, or the loss of noticeable contour around the chin. While these are more common problems that people face as they age, younger men and women may experience them as well due to weight loss, heredity, or a number of other factors.
Juvéderm Voluma injections typically take about 15 minutes to administer in the doctor’s office. The gel formula contains lidocaine to minimize discomfort, so there is no need for additional anesthesia. The injection is designed to reach the deep layers beneath the skin’s surface to provide the most benefit.
The results are visible immediately after the procedure. There is very little or no downtime required following a treatment with Juvéderm Voluma. Most patients can resume all of their typical daily activities right away after their treatment session.
While Juvéderm Voluma is considered a safe form of treatment, all injectable dermal fillers are associated with some risk of side effects. The most commonly occurring side effects that may result from Juvéderm Voluma treatment include swelling, tenderness, the formation of a lump, firmness to the skin, bruising, redness, itching, discoloration, or pain at the injection site. When these arise, they are generally mild to moderate and resolve within a few weeks.
Perlane® is an injectable filler used to soften wrinkles and reduce the appearance of lines and folds for patients unhappy with the effects of aging on their skin. Perlane can be used for lines around the lips, mouth, nose, and forehead, and is especially effective for the nasolabial folds, which stretch from the nose to the corners of the mouth. Perlane is made of hyaluronic acid, as is Restylane®, but contains larger gel particles that can more effectively fill deep depressions on the skin.
Perlane injections typically take 30 to 45 minutes to perform and are administered with a topical anesthetic. Patients can return to regular activities immediately after injections, with no downtime. Results are visible right away and can last for six to eight months, depending on the individual patient’s age, skin condition, and various other factors. Touch-up injections once or twice a year are recommended to maintain results.
Perlane is a safe procedure, but there are risks associated with any procedure. Some patients may experience swelling, redness, bruising, and discomfort after treatment, but these side effects usually subside within a few days. Although rare, Perlane carries a risk of infection, bleeding, or allergic reaction. Choosing a qualified physician for your Perlane treatment can greatly minimize the occurrence of complications.
Restylane® is a biodegradable gel used by dermatologists in injections targeted at smoothing out wrinkled skin. Restylane is primarily composed of hyaluronic acid, a natural substance occurring within the body. This compound is also the only FDA approved dermal filler on the market for use in treating wrinkles. In addition, not only does the injected volume of Restylane add fullness to skin, but it also attracts water molecules to the site of injection, further enhancing its effectiveness.
While inside the body, Restylane provides longer-lasting results that are apparent almost immediately after injection, although it may take a day or two before natural body processes and swelling subside. A follow-up appointment will be scheduled for a later date (4-8 months) for another set of injections to further prolong the effect.
There are very few complications associated with Restylane. The compound itself is derived from bacterial origins, so most allergies should not be an issue (unless specific to bacterial proteins). The side effects are minimal and will not interrupt your daily routine. These may include:
These will all subside within three days or less as your body adjusts to the new hyaluronic acid. Consequently, the suggested recovery period of Restylane treatment is just under three days. It is advised to refrain from rubbing or massaging the treated area for approximately 48 hours.
Sculptra® Aesthetic injectable is used to reverse the signs of facial fat loss that occur with aging. By restoring collagen, which decreases as the body ages, it fills out shallow-to-deep wrinkles and folds that run from the sides of the nose to the corners of the mouth (nasolabial folds). It is not appropriate for use in the eye and lip areas.
Sculptra Aesthetic’s main component is an alpha hydroxy acid called poly-L-lactic acid (PLLA), which is a safe and long-lasting synthetic (artificially created), biocompatible (can be used harmlessly in the body), biodegradable (able to be broken down by the body) substance. PLLA has been used for more than 20 years in many surgical products, including dissolvable sutures and soft-tissue implants.
U.S. Food and Drug Administration-approved for the treatment of nasolabial folds, Sculptra Aesthetic is considered safe and effective for most patients. Because it works gradually, patients achieve a more youthful, natural-looking appearance with subtle, yet noticeable, results. Although not FDA-approved to treat them, according to manufacturer Valeant Aesthetics, Sculptra Aesthetic can be used on marionette lines (at the corners of the mouth) and chin wrinkles. Because it contains no animal, human or bacterial components, allergy testing is not necessary prior to treatment. There is little-to-no downtime after receiving Sculptra injections; most patients return to their normal activities immediately.
Sculptra Aesthetic injections are designed to be a one-time treatment. A patient can have up to 4 injection sessions, which are spread 3 weeks apart. When injected into shallow-to-deep folds and lines, the additional collagen that is produced smooths them out and adds volume to the skin. Results of Sculptra injections vary but, in a clinical study, their effects were shown to last for up to 2 years in most patients.
Possible side effects of Sculptra injections include localized bleeding, tenderness, discomfort, redness, bruising, and swelling. Side effects usually fade within a few days, although can last longer.
According to Valeant Aesthetics, “Other side effects may include small lumps under the skin that are sometimes noticeable when pressing on the treated area. Larger lumps, some with delayed onset with or without inflammation or skin discoloration, have also been reported.”