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Botox, Dysport, Xeomin or Jeuvveau?

Botox & Dysport…What is it used for and what age should I start? It might seem hard to imagine there was ever a time before Botox, but it is actually newer than you probably think. Botulinum toxin A has only been used for cosmetic purposes since 1996.  Over the course of its short history, Botox has become a household name. New applications have also been found for Botox in the cosmetic realm, from scalp injections to keep hair clean and styled longer, to foot injections to help avoid the pain associated with wearing high heels. Botox is used for treating areas of the face that are prone to developing lines and wrinkles from muscle activity.  Botox will typically last about 3-4 months, depending on the person and their activity level.  We find that people who workout a lot tend to need Botox / Dysport much sooner.  Immediately after the injections you can expect small bumps in the area that the Botox / Dysport was injected.  These small bumps will resolve in about 5-10 minutes as it is absorbed into the muscle. How long until it begins to work?  Botox will usually start working in 8-10 days, where Dysport will begin working in 3-4 days.  Xeomin and Jeuveau will typically take about a week to start working.  We recommend waiting at least 2 weeks before you see your final results. Which one will last the longest?  This is a very difficult question to answer, because there are many factors.  Some men have very strong muscles and may need more botox than others.  The more Botox, Dysport, Xeomin ect. that you put in, the longer it will typically last.  When you only use a small amount of Botox, Dysport the results tend to not last as long.  It is a very personal preference regarding how much Botox a person may want, and how much movement they want as well.  Too much Botox or Dysport may tend to have a negative effect by causing the eye lids to become droopy. What age should I begin Botox or Dysport?  This question should really be – How strong are the muscles?  I have women in their 50’s who have never had Botox or Dysport and they have no wrinkles.  I have women in their early 20’s already developing deep lines, so I goes to show age has nothing to do with it.  I generally recommend around 30 being a good age to start with a small amount.  Women doing Botox or Dsyport in their early 20’s as a means of prevention, I will recommend smaller doses at 6-9 months or even once a year.

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Science behind Facials

Have you ever wondered what are the actual benefits of a facial?   Many people enjoy a facial because it is very relaxing and makes your skin glow.  There are actually many benefits you can gain from having a facial or HydraFacial. If you think that facials are a waste of an hour (and money), think again! Because your skin is missing out on something that’s good for it.  There are hundreds of pressure points on your face that are connected to various systems in your body. When these pressure points are massaged, your body will respond.  A good facial massage not just keeps your skin glowing, but it also affects the functioning of the other organs.  And since it is not possible for you to know all the pressure points, you need to visit a professional to get that facial massage. Facials help to thoroughly clean the face by unclogging the pores and exfoliating dead skin.  Exfoliation is the process where the dead skin cells are gently sloughed off your skin’s surface. The cells die and tend to pile up on the surface (if not removed), making your skin rough and dry. While you can exfoliate your skin using a scrub at home, if you want to remove the dead skin cells properly, going for a facial is the best option. It involves using chemical peels that thoroughly clean the skin surface, revealing a healthy layer of skin beneath. Regular facials and face massages increases cell regeneration and promotes collagen.  This gives you younger looking skin!  With age, your skin loses its elasticity as the production of collagen diminishes. During facial treatments, the professionals use chemical peels, face packs, masks, lotions, and creams that are enriched with botanical extracts that stimulate the production of collagen and reduce the signs of aging. Even if you do not have blemishes, hyperpigmentation, severe acne, or any other problems, your face needs to be pampered by a trained professional to keep it healthy. How often should you have a facial?  In an ideal world, a facial should be performed every 4-6 weeks to keep your skin looking fresh and remove old dead skin. HydraFacial uses patented technology to cleanse, extract, and hydrate. HydraFacial super serums are made with nourishing ingredients that create an instantly gratifying glow. HydraFacial is a skin treatment available in medical spas and dermatology offices. It’s also sometimes called “hydradermabrasion” because it involves microdermabrasion-like exfoliation combined with hydrating serums. Known for its three-step process, the HydraFacial works to deep-clean, exfoliate, and hydrate your skin. This professional procedure may help treat a variety of skin conditions, including acne, dryness, and wrinkles. The noninvasive procedure is similar in principle to a regular facial you might get from a spa but is said to provide more dramatic results. This is achieved by a mechanized wand used on your skin to deeply clean and exfoliate while delivering serums customized to your skin type. If you’re curious about whether a HydraFacial is worth the hype, read on to learn more about the potential benefits, the possible side effects, and how it compares to similar treatments.

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Morpheus8 Skin Tightening

Morpheus8 is a revolutionary technology that goes beyond what was ever thought possible.  Morpheus8 goes deep below the skin to help tighten the connective tissue, which is something no other treatment on the market can do.  Microneedling only works on the top layer of skin, which makes it helpful for fine lines and wrinkle as well as reducing pores.  Unfortunately microneedling does NOT tighten skin, as many estheticians will lead you to believe.  Other devices that use microneedles and radio frequency do not have the same power that Morpheus8 has.  In our practice, we have many client who see results even after the first treatment.  Typically this Morpheus8 requires 3 sessions for optimal results, and you can even do more. Morpheus is safe on skin types up to and including VI with little risk of post inflammatory hyperpigmentation (PIH) which is common with other resurfacing methods.  Treatments are performed every 2 months to allow your ski to repair itself.  Younger patients may do it every 30 days since their skin recovers at a faster rate.

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Facial Contouring and Sculpting

When we talk about slimming the face or contouring the face, this can be done in different fashions.  Typically the lower part of the face is what people want to slim down in order to have that V shaped face.  Over time and with age, the lower part of the face tends to sag a bit.  With age we tend to get what are called “Jowls” that hang down.  These jowls result from a lack of supportive tissue and deep fat, which typically helps hold everything up and in place. Slimming the face can also be useful if you have a very round face, and you are looking for more definition. Fillers are the easiest way to lift up a small amount of sagging from the lower face.  Fillers need to be placed in the midface to help volumize the areas that have lost their deep underlying structures, such as fat.  Fillers can be a slippery slope, because you need to have the right amount of filler placed so that you do not become over filled.  People will often try and talk you into fillers and more fillers to lift the lower part of the face, leading to an over filled fat looking face.  Fillers in the face should be used with caution, and used more for balancing the face. Kybella can be used to remove fat from the lower part of the face as well.  Kybella is injected carefully into the lower part of the face, and only into the fat areas.  The injection of Kybella will result in swelling for 2-3 days.  You must keep in mind the swelling that happens when injecting Kybella, since some people have severe swelling after.  Kybella will need to be done at least 3-4 times to get the desired results.  The problem with Kybella, is that is indiscriminately kills fat, and not always in the exact spot you may want. Agnes is a new way to precisely destroy small areas of fat.  With this procedure, we can target very small areas of the face to remove fat.  Agnes allows us to actually chisel out and sculpt the face.  With this procedure, there will be some mild swelling as well, but not to the degree Kybella swells.  When we use this machine, we always like to combine it with Morpheus8 to help tighten as well for best results.  Agnes is currently the best way to remove small areas of fat, and it is what we get the best r with.

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Dark circles under eyes

One of the biggest complaints that people have are the dark circles under the eyes.  There are many different causes of darkness under the eyes, such as being tired, lack of volume under the eye, thinning skin, blood vessels, dehydration.  Unfortunately there are no creams out there that will cover this up or make it better.  Most people are not aware that there is a simple fix.  By placing dermal fillers under the eyes, called the tear troughs, this restores lost volume.  In most people, there is a fat pocket in this area that keeps it full and plump.  Many people have had sunken in areas around there eyes for many years, while others notice it later in life.  As we age, we loose fat (deep fat and superficial fat), by simply replacing the lost volume it will bring about a more youthful appearance. Our technique is different…  We use what is called a “Microcannula” to access the area under the eye.  Why is this important?  By using a microcannula, it travels under the skin and is a small flexible tube.  Due to the flexibility, the microcannula will not puncture blood vessels as easily as a standard hypodermic needle.  For this reason, areas that were thought to be too difficult to get to, can now be easily accessed.

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TruSculpt for Killing Fat !!

Some great new technology to hit the market with amazing results is… TruSculpt ID.  What is TruSculpt?  TruSculpt uses radio frequency and heat to destroy fat cells.  Fat can be destroyed with heat, cold or chemical injections such as Kybella.  Up until now Coolsculpting was the most well known non-surgical way to destroy fat.  The problems with Coolsculpting was that it could cause nerve damage and leave the area numb for a month.  Coolsculpting also would cause a lot of bruising after the treatment.  Trusculpt ID leaves no signs of treatment, and there is no downtime.  The radio frequency used with TruSculpt also helps tighten the skin, whereas Coolsculpting kills fat and leaves the skin loose.  Multiple treatments are great to get to the ideal body that you are looking for.  The best part is that the treatment is ONLY 15 minutes!

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Restylane Kysse for lips

For many years Restylane Kysse has been used overseas in Europe for lip injections.  Recently Restylane Kysse was approved by the FDA in 2020 for use in the lips for plumping and making fuller lips.  Restylane Kysse is also approved for perioral lines above the lips as well.  Up until now Juvederm has been our favorite filler to use in lips due to its longevity and ability to hold a shape longer.  The makers of Kysse have promised us that this new filler will last 12 months, which we are currently putting to the test.  The nice thing about this filler is that it is very soft and natural feeling.  As far as swelling goes, it is difficult to say if the swelling is less than that of Juvederm or other fillers.  As far as bruising, this all depends on the injector and their technique. Traditionally in the past, soft fillers would mean that it would not last long in the lips.  Because there is so much movement in the area of the mouth, soft fillers tend break down quicker.  Restylane Silk still remains our least favorite and we do not use it in the lips.  Restylane silk breaks down far too fast and we have many unhappy customers who were talked into Silk at other facilities.

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PDO Thread Lift

PDO Thread lifts have become a very popular procedure for lifting up sagging jowls and creating “Natural” volume from collagen production.  We have been performing for over 4 years and were the first in Arizona to perform this procedure.  Over the years our technique has changed and evolved to what we consider to be the best in all or Arizona.  PDO threads can be very difficult to place unless you have performed many of them.  Threads (sutures) are placed under the skin and anchor into the soft tissue to help lift the face and jowls.  The threads slowly dissolve over the period of a year.  The thread is placed in the hairline so that it is not visible and the end is cut off and slips under the skin.  Lidocaine in injected under the skin where the insertion point will be as well as under the skin.  The procedure takes about 45 minutes, and some times we like to also add a little filler to replace areas of bone and fat loss.  This is a great procedure to help lift and tighten and still maintain a natural appearance.

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Best Filler For Lip Injections?

After using every filler on the market in search of the holly grail, I have narrowed it down to only a couple of fillers.  I have injected every type of lip, with every type of filler, and we are talking about THOUSANDS of lips.  If you ever spend enough time on Instagram you will see all types of fillers being used to perform lip injections.  I will list the worst and best for lip injections- Starting with the WORST…Restylane wins hands down.  Unfortunately this filler is a very thin filler and looks great for a couple weeks, then say goodbye to those lips and you money.  Restylane is a great filler for people who do not like to do lip injections, or they are not good at lip injections.  Restylane is very pliable and corrects easily after any mistakes.  I have so many complaints, and people upset that they were pushed to use Restylane in the lips.  Restylane is sold as a “Natural and Soft” lip filler.  Unfortunately these injectors are heavily influenced by sales reps who have never touched a syringe, but regurgitate what their company tells them to say.   The second worst filler for lips would be Volbella, Vollure, or Belotero.  Again, these are too thin of fillers and break down extremely quickly.  These fillers do not hold their shape and are just too soft to last in a very animated area of the face.  The sad thing is I see many plastic surgeons using these fillers for lips… most likely because they are not good at doing lip injections.  These fillers should be reserved for other areas of the face, which they work very well in. My favorite is good old Juvederm Ultra XC.  Many years ago the drug reps told me to use Juvederm Ultra Plus XC in lips because “It lasts longer” which was not true.  Why did the rep want me to inject Ultra Plus???  Because it cost more.  Unfortunately now both Ultra and Ultra Plus are the same cost to buy.  Juvederm Ultra lasts about 6-12 months.  This filler will have a stiffer fell for the first 3-4 weeks until it softens.  We have had patients lip filler last Juvederm last 2-3 years!!! A new filler on the market as of today is Restylane Kysse.  So far we have heard good things about this filler, but we have not injected enough to know its true potential.  This filler has a much smaller needle (which generally means it is not a thick filler) which makes it much less painful for patients getting their lips done. These views on fillers are strictly our own point view, and the findings are after thousands of lip injections performed.

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Med Spas To AVOID

I have spoken to a lot of people about miserable experiences they have had with other medspas.  Here is what I have learned, and maybe this can help you find the right place. -Does the medspa or office offering services refuse to give out prices over the phone?  This is a red flag.  A reputable office should be transparent with pricing so that you can get an idea of what you will spend before going in. -Do you get stuck in a room with a “Sales Consultant”?  I would say to just walk out at that point, because they are trained to suck as much money out of you as possible.  Sales associates work on commission and don’t care about your financial situation.  They will be more than happy to set you up on Care Credit to get you financed for your services. -Is the office dirty, and the front desk personal rude?  As they always say, first impressions are everything. -Always make sure you know how long the person has been performing the treatments that you are going to get.  Typically a new person will not have the same amount of experience as someone that has been doing that procedure for over a year. -Groupon?  Sometimes Groupon is great, but when it comes to messing with your face spend the extra couple of dollars. -Bait and switch.  I really hate to say it, but there are places that will advertise cheap prices for Botox, then switch another product.  Always offer to come back if they are out of something you really want.  Make sure the product is where you can see it. -Avoid places where people always talk bad about other medical spas.  When people talk bad about other places, it shows they are threatened by competition.  A good medspa will keep their opinions to themselves and focus on you the client.

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