Non-Surgical

Facial Fillers

General Considerations

Realistic expectations are the key to success

Facial fillers and injections can be a complementary procedure to enhance results of other cosmetic procedures.

What will usually be helped?

Relative improvement in the appearance of horizontal forehead wrinkles

Improvement in vertical frown lines

Improvement in crows feet

Improvement in nasolabial fold area

Improvement near or below the corners of the mouth or marionette lines

Reduction in appearance of shallow to moderate acne scars

What will not be helped?

Major asymmetries in the face

Extremely deep wrinkles or acne scars

Jowls and skin laxity of the neck and under the chin

Limitations of procedure

Cannot achieve perfection

Cannot prevent continued aging

Cannot solve personal problems

Goals may be only partially met

Natural asymmetries are difficult to completely correct

Other options and alternatives

No treatment, chemical peel, laser resurfacing, facelift or fat injections

Facilities, anesthesia and surgery

Outpatient procedure

No anesthesia or topical anesthesia

Local (dental) blocks are also available

Recovery

Average time off of work – none

Resume normal activities 1 day

Resume exercise 1 day

Redness: majority gone in 1-2 days

Bruising may occur, resolves in 3 days

May consume alcohol same day

Massage lumpy areas for 3 days

Temporary trade-offs

Discomfort, pain, sensitivity during injections

Swelling, prolonged redness

Psychological depression

Lumpiness

Bruising

Permanent trade-offs

The products usually either wear off or reabsorb, restoring native structures

Minor changes in appearance may remain due to permanent alterations in facial skin muscle structure

Minor potential problems

Prolonged swelling and bruising

Asymmetry

Granuloma

Prolonged redness

Allergic reaction to medications

Droopy eyelids

Major potential problems

Scarring of the skin

Necrosis or sloughing of the skin

Infection

Vessel occlusion in very rare circumstances

Any and all of the risks and complications can result in:

Additional surgery, hospitalization, time off

Important considerations prior to your procedure

It is important to stop using any blood thinners to include aspirin, ibuprofen, NSAID containing medications, Vitamin E, herbal supplements such as ginko biloba 1 week prior to your procedure.

Please start removing all makeup and cleanse your face 1-2 days prior to your procedure. All makeup has to be removed in the areas treated.

Notify your doctor if you are prone to getting cold sores or fever blisters. Prophylactic antiviral medication will be prescribed.

Smoking can have serious side effects on the healing process.

Additional procedures may need to be performed in 4-12 months.

Multiple procedures are usually needed if you have extensive damage from aging or injury.

Skin consistency, type, ethnic background, and age are important factors that should be discussed before the procedure.

The practice of medicine and surgery is not an exact science. Although good results are expected there cannot be any guarantee, nor warranty, expressed or implied, as to the results that may be obtained.

List of common medications to avoid prior to your procedure:

  • Aspirin
  • Ibuprofen
  • NSAIDs
  • Vioxx
  • Celebrex
  • Vitamin E
  • Fish oil
  • Garlic
  • Ginco Biloba
  • Heparin
  • Coumadin
  • Lovenox

Eyebrow & Forehead Nonsurgical options

No treatment

Laser skin resurfacing

Eyelid surgery

Eyebrow Lift with botulinum toxin

Eyebrow lift with Fillers

Aesthetic nonsurgical options include eyebrow lift with botulinum toxin injection around the brow area. This is also known as a chemical eyebrow lift. The concept is based on selective chemodenervation of select muscle groups around the eye to help elevate the lateral brow in a more favorable position while slightly depressing the medial portion or club head of the brow, thus restoring a youthful ark of the brow.

Another option for restoration of a youthful eyebrow is injection of a filler around the brow or fat grafting. This technique restores lost volume and fullness in the lateral aspect of the brow which also gives a brow a lift.

The forehead skin can also be tightened by laser resurfacing with a CO2 laser.

How long will it last?

Usually 5 to 10 years

Laser Skin Rejuvenation

Skin Laser Resurfacing

General

Realistic expectations are the key to success

Laser resurfacing can be a complementary procedure to enhance results of other cosmetic procedures

What will usually be helped?

Relative improvement in the appearance of fine and moderate wrinkles

Improved skin tightening of the face

Reduction of age spots and other pigmentary problems

Reduction in appearance of shallow to moderate acne scars

Laser Resurfacing Gig Harbor

Before – After

What will not be helped?

Thick, porous, sebaceous skin

Extremely deep wrinkles or acne scars

Jowls and skin laxity of the neck and under the chin

Limitations of surgery

Cannot achieve perfection

Cannot prevent continued aging

Cannot solve personal problems

Goals may be only partially met

Natural asymmetries are difficult to completely correct

Other options and alternatives

No treatment

Chemical Peels

Dermabrasion

Resurfacing combined with other procedures

Facilities, anesthesia and surgery

Outpatient surgery under general anesthesia or IV sedation with local

Go home the same day , occasional overnight stay

Recovery

Must have caregiver first 48 hours to ensure that you are safe

Average time off of work 1-2 weeks

Resume normal activities 1-2 weeks

Resume light exercise 2 weeks

Redness: majority gone in 4-6 weeks

Remaining 10% may take up to 1 year

Must wear SPF 50 sunscreen or higher

Temporary trade-offs

Discomfort, pain, sensitivity

Swelling, prolonged redness

Psychological depression

Pigment irregularities

Permanent trade-offs

Possible permanent lightening of the skin tone

Possible demarcations of the treated areas

Possible change in the sheen of the skin

Minor potential problems

Prolonged swelling

Blotchy skin

Prolonged redness

Reaction to medications

Acne, clogged pores or milia

Major potential problems

Scarring of the skin

Malposition of lower eyelid

Infection; can lead to scarring

Reaction to anesthetic or medications

Major pigment irregularities

Any and all of the risks and complications can result in:

It is very important to stop using any skin treatments to include acne , bleaching or peeling agents 4-6 weeks prior to your procedure.

If you have been taking isotretinoin, a drug used in the treatment of acne, by mouth you must stop the medication 12 months before your treatment.

Notify your doctor if you are prone to getting cold sores or fever blisters. Prophylactic antiviral medication will be prescribed.

Smoking can have serious side effects on the healing process that may lead to scarring. No smoking will be allowed 6 weeks prior and immediately after the procedure.

Additional resurfacing procedures can be performed in 6-12 months.

Multiple procedures are usually needed if you have extensive damage from aging or injury.

Skin type and color, ethnic background, and age are important factors that should be discussed before the procedure.

The practice of medicine and surgery is not an exact science. Although good results are expected there cannot be any guarantee, nor warranty, expressed or implied, as to the results that may be obtained.

Skin Resurfacing Aftercare Instructions

General

Once you have experienced one of our expert skin rejuvenating procedures, it will be time to let your skin heal in the most optimal way. In order to help you get the best possible result we ask you to follow a few simple aftercare steps

What will I expect to see in the next couple of days?

Most people will not actually peel, but you may have light exfoliation. You may experience light flaking and redness for a few days. Your skin will feel tight and pulled. Itching can also occur. Everyone responds differently and most patients look quite normal just 1-2 days after treatment

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Before – After

What can I do to enhance the recovery of my skin?

You can start applying non-fragrant moisturizing cream of your choice for normal skin and Aquaphor ointment for dryer skin types as frequently as needed. Do not pick up or pull any loosening or flaking skin. This could cause prolonged redness and hyperpigmentation. Wash your face with non-abrasive face wash regimen of your choice starting the night of the procedure. Dilute vinegar soaks may help loosen up dried skin or crust.

FOR THE NEXT TWO-DAY PERIOD

Do not wear makeup for 2-3 days

Do not apply ice or ice water to treated areas

Do not put the face directly into a hot shower spray. Don’t use hot tubs, steam room or saunas

Do not go swimming, especially in chlorinated pools

Do not participate in the activities that would cause excessive perspiration

Do not use loofas, apricot scrub, or any other means of mechanical exfoliation

Do not direct hair dryer onto the treated areas

Stay cool, drink plenty of water. Getting heated internally can cause hyperpigmentation

Do not apply AHA containing products to your skin as they may be irritating

Apply sunscreen of SPF 50 or above if going outdoors

Wear a wide brim hat

THE DO’S and DON’TS

DO NOT go in the sun or expose yourself to excessive heat

DO NOT pick or pull on scabs

DO NOT go in to tanning booths for 4 weeks after treatment

DO NOT have another treatment until your technician advises you to do so

Discontinue vitamin A-based drugs (called retinoids) for 1 to 2 weeks post treatment

Do not have electrolysis, Botulinum toxin, or any fillers injected or facial waxing/depilatories for 5-7 days

Prolonged redness, milia, acne breakouts, allergic reactions and pigmentary changes can sometimes occur. Please bring this up to your technician at your next visit.

Notify your doctor immediately if you are developing cold sores or fever blisters. Prophylactic antiviral medication may be prescribed.

Smoking can have serious side effects on the healing process that may lead to scarring. No smoking will be allowed 6 weeks prior and immediately after the procedure.

Additional resurfacing procedures can be performed in 4-6 weeks.

Multiple procedures are usually needed if you have extensive damage from aging or scar injury.

Skin type and color, ethnic background, and age are important factors that may influence the outcome of the procedure.

The practice of medicine and surgery is not an exact science. Although good results are expected there cannot be any guarantee, nor warranty, expressed or implied, as to the results that may be obtained.

Frequently Asked Questions:

Q: What if I am prone to forming dark spots on my face from prior peels?

A: Sometimes your skin may need to be preconditioned with a bleaching agent such as hydroquinone (HQ) and Vitamin-A based drugs (retinoids) for 6-8 weeks prior to your treatment to help you get the best possible result

Q: I get fever blisters frequently. Should I be treated with antibiotics?

A: If you are prone to frequent fever blister breakouts, you may need to be treated with an antiviral medication starting three days prior and continuing treatment for one week after the procedure. Usually this is reserved for deeper resurfacing procedures

Q: How do I make vinegar soaks?

A: Dilute one tablespoon of white vinegar in a quart of sterile or boiled water. Soak a sponge and place on your face for 10 min.