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Facial Contouring and Sculpting

Agnes /

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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TruSculpt for Killing Fat !!

Body Contouring /

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

Injections /

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 Facial Threading /

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?

Juvederm /

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

Glo Medspa /

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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Why Trusculpt ID out performs Coolsculpting

Body Contouring /

Trusculpt ID is much newer technology than Coolsculpting.  We will list why Coolsculpting is outdated and why new technology beats old outdated technology. Trusculpt is a fast 15 minute treatment that is relatively painless.  There are 6 paddles that are placed on the skin and strapped into place.  Trusculpt uses radio frequency (RF) and heat to destroy fat cells.  You can destroy fat cells either by a thermal event such as freezing or heating, or chemically by injecting something such as Kybella.  Of course liposuction is the best, but not everyone wants liposuction or surgery.  Trusculpt provides results in about 8-12 weeks and has NO DOWNTIME.  There are no signs of treatment and you could literally go to the gym immediately after.  Trusculpt will NOT leave divots whereas Coolsculpting will.  There is also NO bruising involved, where Coolsculpting will. Coolsculpting takes about 45 minutes per area you are treating.  The area will be NUMB for about 4 weeks following the treatment.  Coolsculpting can also be used in limited areas, where Trusculpt can be used in many different areas.  The chances of bruising from Coolsculpting is very high and difficult to hide.  The area being treated with a Coolsculpting applicator must be massaged immediately after the applicator is removed.  The massaging part of the procedure is extremely painful due to the re-perfusion of blood into the area after freezing it. Both Trusculpt and Coolsculpting provide good results, but trusculpt provides a faster treatment.  Trusculpt can be used in tricky or hard to get to areas.  Cost is about the same on both.  Coolsculpting you will be numb for a month, and Trusculpt Zero downtime and no numbness.

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TruSculptID rates higher than Coolsculpting!!

Body Contouring /

TruSculptID is new technology that is gaining huge results in the noninvasive body contouring world.  Coolsculpting is slowly becoming outdated with all the new technology hitting the market.  TruSculpt used heat and radio frequency to permanently kill fat and tighten the skin at the same time, which is something Coolsculpting do not do. Unfortunatly Coolsculpting can cause nerve injury and damage, and will leave the area numb for a month or two.  Trusculpt has no downtime and no signs of treatment.  Coolsculpting can leave bruises, numbness, divots, and uneven areas on top of it being very painful after removing the applicator.  TruSculpt treatment in ONLY 15 minutes!!!  Coolsculpting is 30-45 min or even an hour.  Results for both are seen in the same amount of time. truSculpt iD offers a unique and personalized approach to improve upper arm contouring and definition. Unlike other devices, there is no placement limitation, it is easy to set up, and fast to treat. Provide your patients improved freedom to open their arms and wear sleeveless shirts with confidence. Unique approach to treat skin with laxity Sculpt challenging areas Synchronized treatment zones No downtime

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HydraFacial – clean, extract and hydrate the skin

Hydrafacial /

The Hydrafacial is an award-winning system that merges invigorating spa therapies with advanced medical technology to enhance skin health.  The HydraFacial uses patented Vortex-Fusion® technology to cleanse, extract and hydrate.  The HydraFacial helps uncover a new layer of skin with exfoliation and resurfacing.  Remove debris from pores with painless suction, while you nourish with intense moisturizers that hydrate the skin. The facial treatments can be customized to each persons needs and skin types.  HydraFacial Brightalive® Booster Serum is a super serum designed to brighten skin tone and lessen the appearance of discoloration for an instantly gratifying glow.   You can also add red or blue light therapy to the treatment for added benefits.  In cosmetics, LED light has several purported uses: Red light is for anti-aging and inflammation, blue light is for acne, and infrared light to tighten and firm the skin. … Red light stimulates collagen, and blue light kills an acne-causing bacteria called Propionibacterium acnes Another great therapy from the Hydrafacial machine is Lymphatic Enhancements.   Removes toxic buildup to reveal healthy looking skin, helps detoxify the skin, decreases inflammation, removes unwanted buildup, and optimizes skin health

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Botox – Dysport

Botox /

Botox is great for helping to reduce the lines on the forehead, between the eye brows and around the eyes.  Botox works in the muscle by blocking the impulse going to the muscle which causes it to contract.  When there are strong muscles, it causes micro injuries into the epidermis of the skin which cause lines to form where the muscle squeezes together.  Botox or Dysport will not fill in deep lines or wrinkles, so we suggest a “filler” at the point.  Fillers are gel substances that help plump up sunken areas or deep lines. What is a good age to start Botox?  It is hard to say exactly what age is appropriate, but we typically recommend around the age of 30.  A lot of this has to do with the strength of the muscles, and not so much about the age of the person.  We have had 20 year old women with very strong muscles, and I have had 60 year old women with no lines and have never had Botox or Dysport before.  When you are younger, we typically recommend Botox every 6-9 months as more of a preventative measure. Is Botox Safe?  We uses thousands of units every month and have never experienced any severe side effects.  Possible side effects may include a slight headache, blurred vision and flu like symptoms.  These possible side effects only last 24-48 hours and resolve on their own.

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