The New Girl

Being new to the office I didn't quite know how to feel about injections and laser treatments. All I had ever truly known about treatments like Botox were falsities that SNL would spew about wide-eyed emotionless women with permanent half-smiles that were incapable of producing tears. I was happy to find out and witness first hand that this is absolutely not the case in terms of procedures here at Timeless. So I got to go through the new patient process, not only to learn how to better take care of my skin but to also address some of the things about myself I'm less than confident about. If you've read this blog or have been to our office before I'm sure you've heard or read Dr. Carol's tag "look like yourself only better" this can not be more true in my case.

First I had my consultation with Allyson (our PA-C) and not only did I feel comfortable talking about what I see as physical short-comings (which is a pretty big deal for me, outgoing on the surface, but in all honesty a fairly closed off person underneath) but she was honest about what I could and couldn't do to fix things I was concerned about. We figured out a skin care regimen to get rid of some moderate acne (yay Obagi!) and started to delve into actual procedure options. For me this was not only foreign in my world but incredibly scary. What if I don't look like me when we're done? You can't reverse Botox, you just have to wait it out. IPL? You think we should laser my face?! Why would you want to laser my face?!

After she explained how the procedures she recommended and the ones I was interested in worked it was time to move on to some of the actual treatments. I was still a little skeptical about how a laser would feel on my face and how I was going to handle injections in my forehead considering my needle phobia. The IPL was going to refresh my face take away some of my dead skin just to give me more of a fresh start. It was a warm feeling and just made me a little jumpy every time I was "zapped". After we were done with that I had just a slight redness but it was nothing compared to some of the epic sunburns I've had on my fair skin. And the redness disappeared within a half an hour.

Next, the big one, Botox. I'm a person that has a lot of movement and expression in my eyebrows. Only being 24 I had already accepted the fact that as I age I was probably going to be cursed with deep wrinkles in my forehead and between my eyebrows (or the "elevens" as I learned they were called). I laid down and when I was told how many units were being injected I was pretty shocked to know how much I needed. In reality though the number of units is actually more than the number of needles actually needed for the injections. A small relief for the needle-phobic. All I could really feel was gloved fingers on my forehead, 95% of the time I had no idea needles were going into my skin unless I could see it right above my eyes. It was an amazing learning experience that I'm incredibly thankful for.

Bottom line for all of the readers: you don't need to be afraid of needles, consultations or procedures here at Timeless. There were even some procedures that I was interested in that in my initial consultation Allyson told me were completely unnecessary. In addition to loving my new job it's nice to know that there are still businesses that are more interested in the best interest of their employees and patients and not the extra stuff they can slap on.

Looking forward to meeting all of you as you come into the office!

Pump up the volume!

As the number of days shortened before my 47th birthday I noticed what many people notice as they age – the loss of volume in my face!

It is a simple fact that as we age we lose facial volume. This loss of volume tends to be the most noticeable around our mouths, eyes and lips. Although Dr. Carol has injected filler into my nasolabial folds, which run from the side of the nose to the corner of the mouth, as well as under my eyes, I had not yet tried filler in my lips. To be honest the thought of having filler injected into my lips was scary! I was fearful that I would look like either Lisa Rinna or Daffy Duck – neither of which was very appealing to me.

Even with the thoughts of Lisa Rinna rolling around in my head, every time I looked in the mirror I was very aware of my disappearing lips and I really wanted to do something about it.

The plan … I decided to trust Dr. Carol, as I have so many times before, and have my lips injected. Dr Carol injected 2 ml of filler into my lips and around my mouth. Was I scared? Yes, but I knew I was in good hands with Dr. Carol as she is a top injector of filler in the area.

The result … I could not be happier! My lips look fantastic! It’s just as the Timeless tagline reads: “Look like yourself only better”. Perfectly stated. My lips don’t look crazy, actually they look perfectly natural. I followed both the pre and post procedure instructions and had minimal bruising and swelling. As soon as I get someone in the office to take an after photo I will post my photos. Feel free to stop in the office and check out my new lips!

If you have any questions feel free to call our office or you can contact me directly at kristy@timelessskinsolutions.com.

Acne Management

This Friday, February 19th, from 12:00-1:00pm, I will be holding an informational seminar on acne. Below is an idea of some of the things I will be talking about. Please stop by if you have any questions!

Many people, young and old, male and female suffer from acne. Acne breakouts range from low inflammatory bumps and papules, to more severe inflammation with deep, red, protuberant cysts.

Commonly used over-the-counter products are frequently ineffective, and tend to dry out the skin, causing rebound oil production rather than cure the underlying source of the breakout . Medically directed skincare provides a proven advantage over these over-the –counter options. These products are purchased with a medical license and have a higher percentage of active ingredient to treat to area of concern.

For all skin types, Clarisonic has an at home ultrasonic cleansing brush which helps with deep pore cleansing. For dry or sensitive skin, cleanse with an mild cleanser, followed by a beta-hydroxy (salicylic acid) preparation in the form of a toner or lotion, and moisturize with a vitamin B hydration lotion. For very oily skin, the amount of acid in your wash can be increased. If your breakouts are isolated to just the forehead or shoulders, it may be a reaction to a hair product. It may also be pityrosporum, which responds to anti-fungal treatment.

If you have acne, it’s best to avoid wearing makeup if you can. But if you must, choose a makeup with a mineral base, such as zinc and magnesium, which have a calming effect on the skin. When you buy makeup, ask if it’s preservative-free, so that it soothes your skin and doesn’t clog pores.

If acne is not resolving with the above measures, silk peels and/or chemical peels are the next step. Both help prepare the skin by removing its surface and uncovering the follicles so that topical preparations can be absorbed. These two treatments can be done together for a quicker response, but the resulting dryness and peeling will be more noticeable.

Remember, when treating acne, it may get worse before it gets better. Two days after a chemical peel, the skin will flake and acne can flare for about two weeks. A skin cycle is 28 days, so you won’t see the full effect of any treatment for about a month.

If you have greater acne inflammation, or significant cyclical breakouts, you can try light-based therapies. These include a series of blue light treatments to absorb a by-product of the bacteria in the skin or Levulan with photodynamic therapy. Following Levulan, the skin will redden, peel and flake for about 3-7 days. Acne may flare after the first treatment, but a series of three treatments usually results in permanent changes to the skin. This treatment is also effective for cancerous and pre-cancerous lesions.

Prescription topical or oral antibiotics can be effective with used in conjunction with topical treatments. Commonly used antibiotics include clindamycin, erythromycin, and minocycline. Azaleic acid also has antibacterial activity and can improve hyperpigmentation that sometimes occurs with acne. Topical retinoids, such as Retin-A™ and Differen™ are also often prescribed. Oral contraceptives and Spironolactone can regulate hormone-related breakouts. Accutane™ is reserved only for the most severe cases of acne that haven’t responded to other therapies. This is a drug with potentially serious side effects, and all the facts should be considered before initiation of this regimen.

That clear skin you dream of can be reached. Be patient and remember that there is help for acne today!

What would Dr. Clinton do?

Well, if you are wondering "what has Dr. Clinton been up to?", I thought I'd share my venture into a surgical experience in January of 2010. I have been bothered by some extra fat under my chin since I finished chemotherapy about five years ago. I had to take steroids at that time and the only thing that really got "pumped up" was the fat under my chin! So, I spoke with plastic surgeonDr. Brian Dorner in November. We decided proceed with liposuction of the chin and neck and he also recommended an upper and lower lid procedure (blepharoplasty) and a forehead lift. As the last three procedures were beyond what I had initially sought the in the consult, I considered his professional advice and agreed with all of the procedures recommended - with the assurance that I'd look better but not "surprised" or "hollow" or looking like a clown. The procedures took 4 hours. I was in excellent hands during the procedure. As I requested to be awake during the procedures, I received valium and local anesthetic. I would not recommend "being awake" for the faint of heart! The liposuction of the neck was by far the easiest part of the journey. The process to recover was much more intense than the nonsurgical alternatives, so if you are considering doing any surgical procedure, please be prepared for some "downtime" that goes beyond just "social downtime." The swelling and bruising have resolved at this time and I am quite pleased with my results and the care I received from Dr. Dorner and his staff. In preparation for the procedure, I had a Titan treatment of the neck and have followed it up at this point with a chemical peel. I plan on adding an IPL, Pearl, Filler and Botox procedure shortly. I used my Skin Medica TNS Essential Serum during the healing phase as well as my Clarisonic Brush and Opal. If you'd like to know more about the process of a surgical experience or have questions - please feel free to drop me an email at drcarol@timelessskinsolutions.com and I will do my best to answer your question. I'll get some before and after photos published here shortly!

TSS Investigates - DIY Botox

If anyone knows that value of a dollar, it’s me! I’m a coupon-clipping, rewards card-holding, price comparing and negotiating, black Friday shopping maniac! But one sacrifice I would never make – putting my health in danger just to save a few bucks. In my eyes, it’s just not worth it.

I came across an article the other day from the Lincoln Journal Star reporting on a burglary at a plastic surgeon’s office. It was your typical, everyday robbery – “…stolen items included a flatscreen TV, a laptop computer, two digital cameras and cash…” and “…six boxes of botulinum toxin type A,” AKA Botox! Wait a second, did I read that correctly? They stole $3,150 worth of Botox? What would two of Lincoln’s finest do with Botox vials?

“Well you know people are illegally selling Botox on the internet now?” Kristy later informed me. That sparked my interest – and I immediately started my search to find Botox for purchase online – without a prescription & without an MD at the end of my name.

I discovered a fantastic article by Lorraine Fisher from the Dailymail.com, with, what I think, is quite a show-stopping title “Poison-by-post.com : The terrifying new trend that could paralyze, blind or even kill you.” I mean if that doesn’t scare you, what would?

Lorraine did all the leg work for me – she researched sites online where you can purchase Botox and actually bought some. It seemed so easy - she simply searched “buy botox”, a website appeared, she selected three vials and headed to the online check-out. The Botox soon arrived, without any instructions on how to transform this gel-like substance into the liquid Botox we all see when at our physician’s office. (In case you aren’t aware, Botox is actually shipped in solid form and the physician combines that with sodium chloride before injecting a patient).

This might seem all fine and dandy up to this point – but let’s just bring to light some of the more “shady” things Lorraine ran into during her purchasing experience. The first, and most obvious red light is the fact that you can only pay with Western Union or Moneygram transfers. And even further, the money was to be sent to some lady with a fake name in Chisinau, Moldova. If Western Union asked you what the money was for, you were told to lie and tell them the money is “…for your relatives or for a friend in need.” Lastly, another little known fact about Botox is that it must be kept cold – in fact it’s packed and shipped in dry ice when sent to our office from Allergan. But was Lorraine’s illegitimate botox packed in ice? Nope, it was sent in a plain old envelope, so after all that, if by some miracle the product she received was really Botox, by the time it got to her, it wasn’t good anymore.

As I read through more articles, what seemed to interest me the most was not the physicians’ opinions on DIY Botox but instead the comments left by the public about the subject. Comments ranged from one end to the other; from citizens concerned for those who would take such a drastic step just to save a few bucks; to comments defending these online illegal drug stores; to those who think we should just all mind our own business and let people do as they please. I even saw a post from a past employee of one of these websites claiming her innocence of the whole situation.

I'm not trying to make up anyone's mind about this - after all, from what I've read, this seems to be quite a touchy subject - but I just don't see how risking your life is worth saving some money. Like any prescription you receive, there are possible side effects of Botox, side effects that are hightened when you aren’t fully trained to be dispensing the drug.

Allergan (makers of Botox) suggest seeing "dermatologists, plastic surgeons, ophthalmologists, otolaryngologists (ear, nose, and throat doctors), or other physicians specializing in cosmetic procedures [because they] are generally more experienced." On the Botox website doctors are listed for your convenience based on zip code so you can be sure you are seeing a trained, experienced physician.

So why take the risk?

References:

"Poison-by-Post.com: The terrifying new trend that could paralyse, blind or even kill you" http://www.dailymail.co.uk/femail/article-1178137/Poison-post-com-The-terrifying-new-trend-paralyse-blind-kill-you.html
"DIY Botox: Site Offers Injectable Drug Without Prescription - With How-To Video" http://www.wired.com/wiredscience/2009/10/botox-without-prescription/
Botox Cosmetic Official Website: http://www.botoxcosmetic.com/index.aspx

No More Make-Up!

What does every girl want? ...Not to have to wake up every morning and feel like you can't leave the house without slathering on a hefty coat of make-up to hide the imperfections of age and sun-damage. Well, I am here to tell you that, thanks to Dr. Clinton and the Pearl laser, I have now officially achieved that goal!

I am now 3 weeks post my Pearl laser procedure with Dr. Clinton and I am LOVING the results! Not only are my fine lines smoothed out, my texture improved and my pore size reduced, but my hyperpigmentation has also vanished!

I can't tell you how good it feels as a new Mom to have the priceless luxury of not having to take the time to apply make-up every morning. To be able to spend 5 extra minutes playing with my new baby instead of standing in front of the mirror getting ready for work. To be able to snuggle cheeks with my little girl before leaving the house and not have to worry about what toxins from my make-up are getting on her fresh baby skin. What a gift!

Thank you Dr. C! The gift of 5 extra minutes in the morning is INCREDIBLE!!!

NEW PRODUCT ALERT - The Clarisonic Opal! - How Do Our Patients Feel About it?

Clarisonic, the makers of the Clarisonic Brush [a staff favorite!] just came out with a brand new product using the same gentle micro-massaging movements as the Clarisonic Brush & the Sonic Toothbrush, but geared toward your under-eyes. Although the product was just released on Tuesday, our office was lucky enough to receive a sneak preview of the product about 30 days ago. We were given some Opals for us and some of our patients to try out before the product was even on the market!

We asked our “test” patients to supply us with some basic feedback of the product, based on 7 simple questions;

Was the product easy to use?

Was it difficult to add to your normal skincare routine?

Did you see immediate results?

Did you apply other product(s) either before or after use?

Did you like the serum that came with the product?

Did you use any other product in the opal, instead of the serum?

Do you have any major complaints?

At a quick glance of the responses, the feedback was great! The product was easy to use and effortless to add into a normal skin care regimen. It seemed that the big amazement for everyone was the immediate results you could see after using the Opal. One patient exclaimed, “Actually, much to my surprise…I could see an immediate difference in the reduction of small lines around my eyes!” Based on feedback, the best time to use the Opal seems to be after cleansing as you apply your facial moisturizer. Instead of patting in the eye cream you currently use, simply switch over to the Opal and in the same amount of time, you can expect immediate “plumping” of the skin around your eyes.

Another praise we heard from our patients is the futuristic appearance of the Opal itself. Not only of the sleek outer shell, but also in the trendy design of the charger – even being compared to the Wii remote charger. One patient loved “the magnetic click you hear when you set the Opal on its charger base.” Some did experience a little confusion when first setting up the charger, because it is so different than most product chargers in the industry – and for that very reason we have an Opal laid out in the office so you can play around with it before you take yours home!

A specially formulated Anti-Aging Serum is included with your purchase. The Opal has not been clinically tested using any other product besides this serum – but we know how attached some are to their eye creams (myself included with the TNS Illuminating Eye!) - so we were interested to see if some of our “test” patients used their favorite eye product instead of/or in addition to the serum. Every patient liked the serum included, noting that “It has a very nice consistency and smell to it. Very cosmetically elegant,” and “…it's smooth and disappears quickly.” No one seemed to use one of their products in the Opal, in place of the serum, but instead just used their favorite eye cream before use, and then continued with the regimen after use (i.e. Essential Serum, sunscreen, Vitamin C).

I know what you all are wondering - were there any complaints? Not one patient had a MAJOR complaint about the product, just a few small concerns or unanswered questions. First of all, one patient showed interest in learning more about the serum itself; what ingredients are in the serum and what went into the development of this serum to work hand-in-hand with the Opal. We went straight to Clarisonic for that answer, and here it is:

“Our Anti-Aging Sea Serum was scientifically developed for optimum results with the Sonic Infuser. Key points about our Serum are… specific viscosity (thickness and consistency) to work best with the cupped applicator tip [and] specific rheology (the physical way that it flows) to work with the dynamics of the Sonic Infuser.”

Ingredients include, “…Key marine and botanical ingredients to hydrate (Trehalose); to firm and tighten (Glycosaminoglycans and Kigelia Africana Extract); and to soothe and protect (Canadian Willowherb). As well, our serum has a natural preservative derived from naturally occurring substances and is Paraben free.”

Other patients expressed a need for more instructions on use, “…how much pressure to add or how to rotate…because it's so different from the Clarisonic Brush and it's close to the eye.” That is a great question, and based on our experience, both with the Clarisonic Brush and so far with the Opal; pressure is not really needed. What’s so great about the Clarisonic Brush is that the sonic vibration shakes and lifts dirt and bacteria out of the skin without much pressure at all. Same with the Opal, the gentle vibrations will plump and softly infuse the serum into your under eye area – doing all the work for you, no need to add additional pressure!

Another question that frequently arose was the expectation of how long the serum will last and how many applications you should expect with each serum. The answer there is - 180 applications, 90 per eye at twice a day – so you can expect the serum to last you 45 days. If you choose to use the product once a day, then obviously you will see a longer life from the serum – it’s up to you and your face!

Now for some fun! What other advice or insider information did our patients have for future Opal users?

“…it is great for when your sinuses are full after a nights sleep and you want to reduce the puffiness under eyes!”

“I shared the Opal with my husband before a party for instant plump!”

“The Opal is really great for travel… It's small, looks good and comes with a great little bag. “

“I am going to use the Clarisonic on just one of my eyes for the next few months. I will do it in the morning everyday after I wash my face with my regular Clarisonic Brush.” – Stay tuned for some before and after pictures!

After you try out your Clarisonic Opal – please let us know how you like it! We would love to hear your thoughts and I’m sure those interested in buying the product would love to hear them as well!