Men and women interested in laser hair removal at my Boston area practice often ask me if this procedure can be used on sensitive areas of the body, such as the face. While the general answer to this question is “yes” – laser hair removal is safe for sensitive areas– it’s important that patients understand laser hair removal before receiving treatment. Here’s what you need to know about the safety and effectiveness of laser hair removal:

• Laser hair removal targets hair follicles with a high concentration of melanin, which can make it ideal for darker hair.
• Laser hair removal usually is safe for delicate areas of the body, such as the face or bikini line, since the laser does not affect the surrounding skin or tissues.
• Due to the hair growth cycle, a series of treatments is typically needed to see complete results.
• Advancements in laser technology can now effectively target a wider range of hair colors and skin tones.
• Lasers can treat large areas of the body, such as the legs, as well as smaller regions, such as the upper lip or eyebrow.

People often assume that eyelid surgery in Boston always involves correction of both the upper and lower eyelids. In reality, upper eyelid surgery and lower eyelid surgery are distinct procedures that are chosen for different reasons. If you are thinking about improving the appearance of your eyes, the following list of concerns may be helpful in determining which procedure is best for you.

Concerns

• Under eye puffiness: Individuals who are worried about the appearance of “bags” under their eyes can benefit from lower blepharoplasty (eyelid surgery). This creates a more rested look by removing excess fat deposits below the lid.
• Under eye hollowness: Lower eyelid surgery can include the repositioning of fat pads to add volume to depressed or sunken under eye hollows.
• Lines and wrinkles: Lower blepharoplasty can reduce the appearance of “crow’s feet” or lines around the eyes by removing excess skin and smoothing the lower eyelid.
• “Opening up” the eye: Individuals who suffer from eye “hooding” or a droopy upper eyelid may benefit from upper eyelid surgery. This removes excess skin and fatty tissue and can even improve impaired vision caused by eyelid sagging.
• Creating definition: Upper blepharoplasty can create a more defined eye contour and restore a more youthful eye shape.
• Total rejuvenation: For complete anti-aging benefits, upper and lower eyelid surgery may be combined to address a full range of concerns and refresh the look of the entire eye.

It’s not uncommon for many of my patients to ask for help when deciding between a traditional and a liquid facelift in the Boston area. While both procedures have benefits, it’s important to understand what each can offer before determining treatment.

Facelift Surgery

Facelift surgery is often chosen to tighten and firm the skin in the lower face and neck. I typically combine a traditional facelift with an endoscopic mid-face lift to elevate the fat pads of the cheeks and create youthful facial contours. This procedure is recommended for individuals who have advanced signs of aging, such as loose skin and muscle in the jowls, neck, and jawline. Advantages of a facelift include:

• Long-lasting results
• More significant improvements
• A defined jawline
• Overall facial renewal

Liquid Facelift

A liquid facelift uses a combination of dermal fillers and BOTOX® Cosmetic to create a temporary lifting effect on the skin. Liquid facelifts are best suited for individuals with more mild or moderate signs of facial aging, and can help restore essential volume to areas of the face that appear sunken or hollow. Benefits of a liquid facelift include:

• Temporary enhancements
• Subtle, natural improvements
• Improvements in specific, targeted areas
• Quick, comfortable treatments

At my practice, patients often ask me if there’s “really” a difference between dermal fillers and BOTOX® Cosmetic in the Boston area. Surprisingly, the difference between these treatments is generally greater than what many people originally suspect. Understanding the purpose of each product and determining which treatment is most appropriate for you depends on what you want to achieve and your skin characteristics.

Dermal Fillers

Injectable fillers such as JUVÉDERM in the Boston area is used to add volume to deflated areas of the face or to fill in wrinkles. These products are made from a variety of materials but usually contain a naturally-occurring substance known as “hyaluronic acid.” Hyaluronic acid is a substance that plumps the skin with essential moisture, giving the appearance of youthful facial contours and reducing the appearance of lines. Many people use dermal fillers to reduce the appearance of pronounced wrinkles, such as those in the outer corners of the mouth (nasolabial folds) or around the eyes. Dermal fillers are also used to add definition to the lips by restoring lost volume and smoothing lip lines and creases.

BOTOX Cosmetic

BOTOX Cosmetic is made from a protein derivative called “botulinum toxin A.” Unlike fillers, BOTOX Cosmetic does not create a plumping effect in the skin, but rather prevents the facial muscles from contracting. When facial movement is reduced, the muscles relax and soften– thereby diminishing the appearance of wrinkles. BOTOX Cosmetic is frequently used to treat forehead creases and frown lines, especially those between the eyebrows.

Combined Approaches

Dermal fillers and BOTOX Cosmetic are often combined to create what is known as a “liquid facelift.” This treatment involves the strategic placement of a variety of different dermal fillers as well as BOTOX into targeted areas of the face to create a lifting effect on the skin. Liquid facelifts are a great solution for men and women who want temporary enhancements without surgery.

There’s good news for individuals interested in tattoo removal at my Boston area cosmetic surgery practice: laser procedures available today are more effective and more comfortable than previous techniques. Whereas, in the past, individuals hoping to erase these “youthful indiscretions” were limited to invasive techniques such as dermabrasion, cryosurgery, or skin excision, effective tattoo removal is now possible with a series of simple laser treatments.

If you are considering laser tattoo removal, here are some important truths to keep in mind:

• Complete tattoo removal is not always possible, but significant fading can occur with multiple treatments.
• Yellow and orange are two of the most difficult colors to remove; blue and black are among the easiest.
• Three of the most effective lasers specifically designed for tattoo removal include: the Q-Switched Ruby, the Q-Switched Alexandrite, and the Q-Switched Nd: YAG. Intense Pulsed Light (IPL) treatments are also highly effective.
• Laser tattoo removal is bloodless, low-risk, and has very minimal side effects.
• Most individuals do not require anesthesia and pain can be controlled with topical numbing creams and cooling.

Cosmetic surgery is not for everyone – it’s costly, requires a large amount of recovery time, and carries some risks. Luckily, there are faster, less-invasive ways to treat an aging face. By using minimally-invasive injectable fillers at my Boston dermatology practice, men and women can experience substantial rejuvenating effects without the necessary downtime required for surgical procedures. Commonly referred to as a “liquid facelift,” this treatment can be performed alone or in addition to other procedures to improve the appearance of jowls, lax skin, and wrinkles.

Restylane®, Perlane® and JUVÉDERM

Injectable fillers such as Restylane®, Perlane® are composed of hyaluronic acid, a substance that occurs naturally in the skin. These fillers add volume and “plump up” the skin to smooth wrinkles and scars or to add volume to the lips or cheeks. Results from these fillers typically last 6-12 months.

RADIESSE®

This innovative filler is composed of calcium hydroxyapatite, another substance that occurs naturally in the body. It is well suited for adding volume to areas such as nasolabial folds (smile lines) and the marionette lines that run from the corners of the mouth down the chin. RADIESSE results may last up to a year or more in some patients.

Sculptra®

Sculptra is a synthetic injectable material known as “poly-L-lactic acid”. Poly-L-lactic acid is biocompatible (does not harm the body) and biodegradable (able to be broken down by the body). Sculptra is an enduring treatment for adding volume to areas of facial fat loss and restoring fullness to facial folds and hollows. Results from Sculptra treatment emerge gradually and may last up to 2 years or more.

BOTOX® in Boston has been used to treat everything from wrinkles to migraines. Due to BOTOX’s well-established safety record, long-lasting results, and simple treatment sessions, this anti-wrinkle injection has become one of the most popular minimally-invasive aesthetic procedures in the world. And now, with the arrival of Dysport®, men and women have even more options when enhancing their appearance.

Like many people who are concerned about reversing the signs of aging, you may have many questions regarding which areas of the face are most responsive to BOTOX or Dysport. In my practice as a dermatologist, I have found that most people benefit from anti-wrinkle injections in the following areas:

• Between the eyebrows

Both BOTOX and Dysport are highly effective at treating “frown lines” between the eyebrows. This results in a softer, more approachable appearance.

• On the forehead

Horizontal forehead creases are also very responsive to BOTOX and Dysport. After treatment, the vertical mobility of the forehead is limited, thereby eliminating frequent creasing of the skin that causes wrinkles.

• Around the eyes

Many people choose anti-wrinkle injections to improve the look of “crow’s feet” around the eyes and to look more awake and refreshed.

• Along the upper lip

Small, vertical lines that develop around the mouth and lips can be easily treated. Patients who previously smoked cigarettes are often the most affected by vertical lip lines, and can greatly benefit from treatment.

• On the neck

The development of “neck bands” results from the muscle weakness that accompanies age. BOTOX or Dysport can relax these bands so that they no longer protrude outward.

Liposuction in Boston is commonly chosen to improve the look of body contours; however, many people don’t realize that liposuction may not reduce the appearance of cellulite. For men and women looking for a noninvasive way to smooth and reshape their body, a new treatment called SmoothShapes® may be a better fit. This cosmetic laser treatment is FDA-approved to improve the look of skin irregularities without lipo in Boston.

Who can benefit from SmoothShapes?

Because SmoothShapes is appropriate for all skin types, almost everyone with skin dimpling can benefit from this procedure. Both men and women with various skin types and skin tones can be treated.

How does SmoothShapes work?

SmoothShapes combines deep tissue massage with concentrated laser energy to target cellulite. The laser beam increases the metabolism of fat cells while also stimulating collagen production to help tighten the skin. Massage rollers help to eliminate the fat cells from the body. Usually, a series of treatments is recommended for best results.

What does a treatment session feel like?

During your procedure, you may experience a sensation of heat and massage. Most of our patients find the procedure very comfortable and do not require any kind of pain medication. Afterward, your skin may be slightly flushed or red, but should return to normal within the next day or so.

How much recovery time is needed?

There is no recovery time necessary after a SmoothShapes treatment. You can return to your normal routine that day, and your skin will continue to look smoother and healthier over the next several weeks.

If you are involved in an outdoor sport such as golfing, tennis, boating, cycling or skiing, you may not realize that you are at a higher risk for developing skin cancer. As a dermatologist near Boston and a board member of the Sun SafeTee charity (which educates golfers about good sun safety habits), I see the effects outdoor sports or exercise can have on the skin. The extra hours spent in the sun, constant sweating, and lack of protective clothing all put outdoor athletes at a higher risk for developing skin cancer.

While it’s not practical to avoid or give up the activities you love, there are measures you can take to protect yourself from the effects of the sun. Here are my top suggestions for safe sun exposure:

• Dress appropriately. Lightweight, long-sleeved shirts and pants are ideal when outdoors.
• At a minimum, wear a hat, sunglasses, and sunscreen with SPF 30 or higher.
• If possible, avoid practicing between the hours of 10 a.m. and 2 p.m. This is when the sun’s rays are most intense and you are at greater risk for sunburn.
• Visit your dermatologist immediately if you see a suspicious skin lesion. Early diagnosis greatly increases your chances for successful treatment.

When women ask me about breast augmentation in Boston, they often assume that they can determine out the right implant size by adding a cup size to their current bra. The reality, though, is more complex.

Implant size and shape

Determining the right size for my patients considering breast implants in Boston involves several different steps. I evaluate each woman’s current shape to determine which implant size is proportionate to her body and related factors. I also discuss each patient’s goals for the appearance of her breasts after augmentation, which takes into account both the desired size and shape.

In addition to improving the size of your breasts, this procedure, also known as augmentation mammaplasty, can help with concerns such as sagging. Various factors, such as aging, pregnancy, or weight loss, can cause a woman’s breasts to droop and lose volume. Breast augmentation also can improve that problem, resulting in a perkier, more youthful shape.

Although this process may seem involved, as a board-certified experienced plastic surgeon, I know that this thorough evaluation is needed to determine which implant size and shape best suits each woman.