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© 2012 Senza Aesthetic Medicine.
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(909) 793-3563
226 Nordina Street
Redlands, CA 92373
Botox (botulinum toxin) is a neurotoxin which affects the nervous system. It blocks the release of acetylcholine which signals muscles to contract. This weakens or paralyzes the muscle temporarily. Purified botulinum toxin for medical use (Botox) is used in tiny amounts that do not affect the entire body but act locally where it is injected.
Using the muscles of facial expression repeatedly over many years can leave deep wrinkles in the overlying skin. These wrinkles can give others the impression that one is angry or stressed out when one may feel the complete opposite. Injecting Botox into these muscles of facial expression relaxes them and allows the overlying skin to lie flat reducing the appearance of the wrinkles.
Anyone who would like to reduce the appearance of frown/worry lines or crow's feet with a minimally invasive procedure.
Pregnant or breast-feeding women, patients who are allergic to albumin, and patients with neuromuscular diseases such as ALS (Lou Gehrig's disease) or myasthenia gravis.
No treatment, surgical brow lift, collagen or other fillers, chemical peel, laser resurfacing works like Botox.
Does Botox work for all kinds of wrinkles?
No. Some wrinkles are created by years of sun exposure or from smoking, both of which prematurely age the skin. These are called static wrinkles and are not produced by underlying muscle contraction and do not respond to Botox. Dynamic wrinkles, on the other hand, are produced by the repeated action of contracting facial muscles on the overlying skin. Dynamic wrinkles are reduced by Botox injections.
Yes. This is a great use for Botox. Treating areas commonly affected with dynamic wrinkles like the forehead and around the eyes before the wrinkles appear can significantly prevent their formation. Botox may also have the effect of training your muscles not to frown or scowl.
How often will I need Botox injections to maintain the effect?
Most patients get about 3 to 5 months of effect from a treatment. However, some patients require more Botox than others. It is better to go slowly than to go straight to a higher dose and possibly develop an unnatural appearance.
We are not sure why, but some patients indeed require less frequent Botox treatments over time. This is probably due to weakening of the muscle or from learning not to use those muscles.
At Senza, Botox sessions are quick and gentle. No anesthetic or sedation is necessary. Patients may resume their regular activities right after their treatment.
It typically takes about 3 to 7 days for the effects to appear.
Yes. There are a small number of people who do not respond or form antibodies to the Botox and stop responding after a few treatments. There is no way to identify non-responders before treatment.
Absolutely. Botox can enhance other treatments and prolong the effects of chemical peels, laser facial rejuvenation or surgical facial enhancements. At Senza, we advocate the use of several minimally invasive treatments which act synergistically to achieve natural, healthy appearing facial skin.
Fraxel Laser Treatment (FLT) from Reliant Technologies is a new aesthetic solution that repairs aging and sun-damaged skin pixel by pixel, spot by spot. We describe it as new-generation laser skin resurfacing, similar to digital photo-editing software for your skin. Think of your skin as a family portrait or digital photo in need of high-quality restoration or touch-up. Imagine how the portrait would be delicately restored, one small area at a time; or a photograph might be digitally altered, pixel by pixel. That's the principle behind the Fraxel Laser Treatment.
Similar to the technique of editing a digital photograph comprised of pixels, Fraxel Laser Treatment precisely produces thousands of tiny columns of treatment zones invisible to the naked eye that target flawed skin and leave surrounding healthy skin untouched. It is the only laser device specially designed to resurface a fraction of skin at a time without breaking the skin's protective outer barrier. This fractional resurfacing affects between 20 and 25 percent of the skin at any one time, permitting the spared tissue to assist in the rapid healing of damaged cells. FLT also reaches deep into the dermis to stimulate collagen remodeling in the skin layers below. In this way, the body's natural healing process creates new, healthy tissue to replace skin imperfections.
The procedure (including the application of topical anesthetic) typically takes between 1 and 1-1/2 hours. Some patients are able to return to routine activities, including work and social obligations, the same day of treatment. Others require a little more time, depending upon their skin condition and treatment. There's no prolonged recuperation, no risk of general anesthesia, and treatment is well-tolerated.
Fraxel Laser Treatment is currently FDA cleared for skin resurfacing procedures; to treat fine lines and wrinkles around the eyes; and for treatment of pigmented lesions, including melasma, age spots, sun spots and dyschromia.
Leading researchers and clinicians have spent the past 3 years testing the safety and efficacy of the Fraxel laser. In Fall 2004, the laser system was commercially launched and has obtained widespread professional acceptance since then. Based on clinical experience to date, doctors are reporting noticeable improvement in patients after 3 to 5 treatments. In our practice, we have observed nice improvements in uneven skin color and wrinkles around the eye area. Our Fraxel laser resurfacing results are comparable to other traditional modalities that are associated with far more significant side effects and downtime.
We have not experienced any significant or long-lasting adverse effects and have we seen a low incidence of post-inflammatory hyperpigmentation and no reported cases of hypopigmentation. The clinical endpoint we look for with Fraxel Laser Treatment is cell turnover and peeling. After treatment, the patient's skin tends to be pinkish-red for a few days with slight to moderate swelling immediately after treatment. This is normal and signifies that the dermal tissue is being repaired and there is good blood circulation. There will be moderate to significant swelling in the treated area for a few days after the procedure depending on the skin's condition and treatment. The repair process typically entails a bronzing that lasts anywhere from 3 to 14 days after treatment, followed by a flaking process of exfoliation as the reorganized epidermal skin gradually replaces dead tissue.
Treatment is well-tolerated with a topical anesthetic ointment to alleviate discomfort. We also use contact cooling to increase patient comfort during the procedure. Patients can apply make-up or shave after treatment.
An effective treatment regime typically requires an average of 4 to 5 treatment sessions spaced about 2 to 4 weeks apart to obtain maximum benefit. Depending on the nature of the patient's condition, the areas to be treated and other factors, treatment costs range from about $600-1500 per treatment depending on the area.
There has been huge patient satisfaction. Our patients are thrilled and word-of-mouth referrals have been tremendous. What makes FLT such a success is that virtually every patient who gets treated experiences a cosmetic enhancement. Treatment offers immediate results softer, smoother and toned skin plus an ongoing, cumulative improvement that creates a healthy, vibrant and youthful appearance.
Our typical patient is someone in their 40s or older who has photodamaged skin lines and wrinkles, skin discoloration, dull or rough texture, age spots, etc. Fraxel Laser Treatment especially appeals to those patients who want the positive results of traditional resurfacing methods with minimal downtime or risks. It also appeals to those who are looking for a more dramatic result than might be achieved with non-ablative techniques. Can Fraxel Laser Treatment be used with other non-invasive treatments? A: In our practice we routinely combine Fraxel with other treatments such as botox, fillers and other minimally to non-invasive treatments.
It is probably too early to know exactly how long the results last but in our experience with good sun protection/avoidance and appropriate skin care maintenance treatments the improvement should last for years.
A very small cannula (tube) approximately 1.0mm in diameter containing a laser fiber is inserted into the skin. The cannula is moved back and forthdelivering the laser's energy directly to the fat cells, causing them to rupture and easily drain away. The laser energy also interacts with the dermis, resulting in skin shrinkage or tightening. Due to the cannula's small size, SmartLipo is a minimally invasive procedure and can be performed under local anesthesia. The laser causes small blood vessels to coagulate immediately on contact, resulting in less bleeding, swelling and bruising - and a quicker recovery time than conventional liposuction. Because general anesthesia is unnecessary, the procedure is very safe, with only minimal side effects.
The benefits of SmartLipo include:
Treats unwanted fat and fat tissue irregularities
Promotes tissue coagulation resulting in skin tissue tightening
Improves flabby or lax skin and areas of high vascularity
Minimal edema and bleeding due to the laser's hemostatic properties
Minimal bruising
Causes less trauma and faster healing time than traditional liposuction
The SmartLipo has been cleared by the FDA for laser-assisted lipolysis.
Yes! The SmartLipo procedure permanently destroys the treated fat cells. Adults do not create new fat cells. When a person gains weight, that person's fat cells simply expand.
If you have areas of fat that will not respond to diet and exercise, then you're a candidate for SmartLipo. Ideal candidates are in good health, of normal body weight and have realistic expectations for the results.
SmartLipo is a great adjunct to traditional liposuction procedures, although it does not replace conventional liposuction. Any area that is normally treated with liposuction can be enhanced with the Smartlipo treatment. It is also ideal for treating small areas of the face, neck, arms, breasts (gynecomastia), and areas of loose skin.
For most patients, typically only one treatment is required. The session may last from 45 minutes to one hour for each area treated. Laserlipolysis is also an ideal choice for "touch ups" and revisions.
After the treatment you will need to wear a compression garment for several days, depending on the body areas being treated, Rest is recommended after the procedure and activity may be resumed gradually. Most patients will relax for several days post-surgery and will resume further activities as their body feels more comfortable.
The procedure will improve the body's shape and may improve cellulite to a certain degree.
Results can be seen as soon as a week with continued improvement over several months.
Laser hair removal is non-invasive light therapy designed to safely eliminate unwanted hair from all parts of the body. The laser generates a pulse of intense, concentrated light directed through a small, cooled hand piece which is gently applied to the treatment site. Each pulse of the laser lasts only a fraction of a second and treats an area just under a square centimeter. The laser energy passes through the skin to the hair follicle where it is absorbed by pigment in the hair and hair follicle. The absorbed light energy is converted to heat which damages or destroys the hair root but not the surrounding skin structures.
Theoretically, any hair follicle can be destroyed using laser energy, no matter where it is located. It is easiest to describe where we will not treat unwanted hair. For safety reasons, we do not attempt to destroy hairs that are very near the eyes (e.g. eye lashes), within tattoos, or within some moles. We do treat hair between the eyebrows (monobrow). Laser energy is not suitable for fine shaping of the eyebrows. We will treat unwanted hair at all other sites.
Women - Bikini line, facial hair, underarms, legs
Men - Back, shoulders, chest, face/neck
Any patient with unwanted pigmented hair (not blonde, gray, or white) may benefit. In particular, Patients who struggle with in-grown hairs, razor burn, abnormal hair growth (hirsuitism/hypertrichosis), time-consuming daily hair maintenance regimens, or for women, hair on the face, are usually very satisfied.
Shaving, waxing, plucking, threading, and depilatories all leave the hair follicle intact allowing hair re-growth in days to weeks. Only laser hair removal and electrolysis treat the hair follicle causing long-term hair reduction. Compared to electrolysis, LHR is extremely quick allowing treatment of even very large areas in a single visit.
Electrolysis is performed by attempting to probe each hair follicle individually down to the root and zapping the root with an electrical charge. The hair is then removed with tweezers. Needless to say this is a slow, tedious, and painful process which is not feasible for large areas such as the back or the legs. In contrast, laser hair removal can treat dozens of hair follicles with each pulse at up to 2 pulses per second! Larger areas are more feasibly treated with laser but it does have limitations. Laser cannot treat grey, blonde or vellous hair (peach fuzz). That is why I routinely refer certain patients who are not good candidates for LHR to an electrologist.
We have two hair removal laser systems: the Cutera Coolglide XEO Nd:YAG, the Lumenis LightSheer Diode and the Cutera ProWave 770. These three systems give us ultimate safety and effectiveness for all skin types as well as some challenging hair types.
Laser hair removal with our laser systems is FDA approved.
Laser hair removal is not quite perfect. Yes, you probably will still have some hair to deal with after you have had a series of treatments but the amount of hair will be much less than you started with and the growth will be much lighter and finer than before. Also you will have more time in between shaving/waxing etc. We have many patients who used to shave their bikini lines daily but now shave only once every few months!! Some areas are more stubborn than others and will take more treatments. Occasional touch-ups will be necessary in many cases to maintain results.
Most patients will require 5 to 7 treatments in any given area. Keep in mind that each patient is different and some patient to patient variation in response does exist. In addition, certain areas like the bikini line and underarms treat better than others like the notoriously stubborn upper lip. As a general rule, the thicker the hair, the easier it is to treat. What is important for Patients to understand is that they will need to have ongoing treatments INDEFINITELY. The interval is variable but most patients visit us 1-2 times a year for maintenance.
All lasers work by killing hairs that are actively growing at the time of treatment. However, many dormant hairs are also present at any given time which do not have as much pigment deep in the follicle; these hairs will not be affected by the laser during that treatment. Because all hairs go through this cycle of active growth, dormancy and regression, multiple sessions are necessary to catch them all in their active growth phase. Wouldn't it be nice if ALL your hairs were growing at the same time and we could kill them in one treatment?! SORRY, that is not the case! In fact, a treatment may only kill 10-20% of the hairs present at the time of treatment. By the time of your next treatment, a new group of hairs will be in their active growth phase and ready to be treated.
Treatments should be spaced at least 6 to 8 weeks apart to allow sufficient new active hair growth for significant treatment.
Yes. Thicker and darker hair is a better target for the laser than light blond hair which may not have enough pigment to be heated by the laser at all. Very fine dark hair may be noticeable and annoying to you, but the laser may not be able to heat it enough to provide a very effective treatment.
High performance laser systems such as those we use have made laser hair removal much safer than in the past. Nevertheless there is a risk of complications whenever laser treatment is performed. These include but are not limited to: blistering, prolonged irritation, hyperpigmentation (spots of darkened skin), hypopigmentation (spots of lightened skin), and burns. Again, these complications are rare and even if they do occur, they typically resolve in a few days to several months. It is extremely rare to have a permanent skin change after laser treatment performed by an experienced and well trained operator.
Yes. We are excited to be able to offer laser hair removal to just about all skin types. Early laser systems had significantly increased complication rates in darker skin types, but some late model systems using longer wavelengths, especially the Cutera Coolglide that we use, have achieved a major breakthrough in safety for dark, tanned, or sensitive skin types.
Technically it is safe to treat a pregnant patient. At Senza we do not treat pregnant patients.
Tanning and lasers do not mix. Your risk of complication is increased substantially if you are tanned or are exposed to sun/tanning booth around treatment time. With our Cutera Coolglide laser we sometimes treat tanned skin for patients who accept the additional risk but we recommend no exposure for 2 weeks before and after treatment.
Yes. Some patients have a better pain tolerance than others, but to be honest, you will look forward to the results not the treatments. We have anesthetic (numbing) cream for certain sensitive areas which can be applied before your treatment and does a great job of making the treatment more comfortable. The good news is that the treatments are typically fast. A bikini line takes about 10 minutes, underarms about 5 minutes and a chin or lip about 1 minute.
One of the great things about laser hair removal is that it does not interrupt your normal lifestyle. Patients routinely go back to work or their normal activity right after treatment.
Another great thing about laser hair removal is that you do not need to grow out your hair before treatment. The hair must be shaved as closely as possible to allow the safest and most effective treatment possible. It should be noted that waxing or plucking removes the laser target preventing destruction of the follicle, therefore waxing or plucking should be discontinued two weeks prior to LHR. Shave as much as you want, however.
The most common post-treatment issue is a little stinging and redness which generally fades in 2-4 hours. You may get some discoloration or mottled skin for a few days but this will resolve on its own. Some patients with very thick/coarse hair growth will get crusting and some blistering which will again resolve in a few days.
The laser does not magically extract the hairs as they are being treated. After treatment, the hairs will slowly be expelled from the skin allowing you to notice gradual lessening of the density of hair growth in the treated area. Do not pluck or pull on the hairs to help them along, they will do just fine on their own. The nice thing is that you will not need to shave as often as usual once the treatments begin.
We will have to avoid the tattoo even if there is unwanted hair growing in the pigmented area. Even some large moles may need to be avoided.
No. Waxing or plucking will remove the hair from the follicle. The hair contains the pigment which the laser targets for the treatment. So, plucking/waxing hair = no target = follicle not treated.
The best way to determine how good a candidate you are is to schedule a consultation with us. We will assess your individual needs and develop an appropriate treatment plan.
Treatment of Skin Redness, Tiny Veins, Brown Spots and Sun Damage
The LimeLight Facial is a new, non-invasive approach to skin rejuvenation using Cutera's LimeLight. The procedure offers the advantage of improving skin tone and surface imperfections associated with aging and photodamage.
The LimeLight Facial is ideal for any part of your face, neck and dcollet with skin redness, telangiectasia (tiny veins) or brown spots. Light (low contrast) brown spots, which were previously difficult to resolve, respond very well to treatment.
By selecting Program A, B or C, your practitioner can customize your LimeLight Facial to your skin type and selectively treat the brown and/or red pigmented areas on your skin. It's the heating of the pigmented brown or red cells that causes the therapeutic effect.
When the pulse of light is delivered, patients will experience a mild pinching or stinging sensation. Gel is recommended to cool the skin before vascular treatments. Anesthesia or pain medicine is typically not required.
Treatment time depends on the area of the body being treated. However, most treatments should take less than one hour.
One to three treatments are usually sufficient to see results.
Additional treatments may be recommended, especially for excessively sundamaged skin.
Immediately following treatment, brown spots will start to darken and your skin may appear slightly red. The treated area may be mildly swollen. This typically lasts a few hours and possibly a day or longer. Make-up can be applied to cover the redness.
Within one to three weeks, the darkened spots will flake off and fade. Diffuse redness or telangiectasia will decrease and your mottled complexion will improve.
New brown spots, telangiectasia and diffuse redness may appear with new sun damage; however they too can be treated. Remember to always apply broad-spectrum sunscreen when outdoors to minimize sun damage and the appearance of new spots and diffuse redness. Rosacea is chronic and cannot be cured with any laser or light source, however its appearance can be improved.
Downtime is the time spent recovering from a procedure. With "social downtime", you can continue your normal daily activities. However, you may not wish to attend important social events because your face will appear pink/red for 3-4 days.
The practitioner guides the Pearl laser over the skin, gently removing the top layer of the epidermis and heating a layer of tissue below it. The treatment takes approximately 10-15 minutes for a full face. The treatment feels like a series of brief pinches.
On a scale of 1 to 10, with 10 representing pain, most people report the treatment feeling like a 2 or 3.
After treatment, the skin will look like it is sunburned. Your practitioner will apply ointment on the skin to keep it moist. The skin will need to be kept moist for 3-4 days. Since you cannot wear sunscreen during this time, you will need to wear protective clothing and limit sun exposure for a few days following the treatment. You are free to wear make-up starting on day 3.
After 3-4 days, the top layer of skin peels off revealing new, healthy, vibrant skin underneath.
You will see noticeable results on day 3 or 4, when the superficial tissue has peeled off, leaving fresh, new, healthy skin underneath.
Patients of any age with sun damage, uneven skin texture and fine lines and wrinkles can benefit from Pearl treatments; however, the most common age group seeking treatment is between 25-60.
Pearl will smooth the skin's texture, as well as soften fine lines and wrinkles, on the face, neck, upper chest and hands.
Many patients experience excellent results after one treatment. Others may want a second treatment for best results.
Pearl offers the most effective treatment to address fine lines & wrinkles, sun damaged skin and uneven texture without wound care and the lengthy downtime required with traditional Erbium and CO2 laser procedures.
Today's fractionated technologies treat only small portions of the face during each treatment. Typically, 4-6 treatments, each with 4-6 days of downtime and spaced a month apart, are required to treat the face.
Yes, Cutera received FDA clearance in March 2007 for Pearl for skin resurfacing and the treatment of wrinkles. Pearl is used primarily on the face but has also been used on the neck, upper chest and hands.
Laser tattoo removal is non-invasive light therapy designed to safely eliminate unwanted tattoos from most areas of the body. The laser generates a pulse of intense, concentrated light directed through a small hand piece which lasts only a fraction of a second. The laser energy passes through the skin to the tattoo ink where it is absorbed by the pigment. The absorbed light energy is converted to heat very rapidly and it bursts the ink droplets into tiny pieces that the body's trash cleanup cells (macrophages) will gobble up.
Theoretically, any area can be treated. For safety reasons, we do not attempt to destroy tattoos that are very near the eyes (e.g. eye liner). We do not treat skin colored inks because they occasionally can turn black irreversibly.
Bad memories associated with tattoo, lifestyle/career change, color change of ink, outdated artwork, fading tattoo for a cover up.
Most darker tattoo colors treat very well i.e. black, dark blue, red, purple. Unfortunately, bright inks are very hard to remove i.e. aqua, light green, fluorescent colors, yellow. Even these inks will fade somewhat but they rarely are completely absorbed.
Tattoo removal has been performed for centuries, even millennia. Burning, sanding, excising, salabrasion, dermabrasion and ablative laser resurfacing have been used but the leave unacceptable scarring. Nd:YAG laser tattoo removal is very safe in all but the darkest skin types. Scarring is rare and the success rate is high.
We use the Palomar Q-YAG 5 laser system. This is an Nd:YAG Q-switched laser system. Having used other systems (medlite) in the past, we are very happy with the treatment response with this laser. We have noticed more fading per treatment and less treatments overall with the Q-YAG 5.
Laser tattoo removal with our laser system is FDA approved.
There are many factors involved in the success of tattoo removal. The most important are, color, age, whether tattoo is professional or amateur, genetics etc. As a general rule, professional tattoos are more difficult to remove than amateur or (garage) tattoos. Old tattoo are easier than recent because some ink is naturally absorbed over time in any tattoo. We cannot guarantee how much of the tattoo will be removed. Sometimes there is a shadow or ghost of the original tattoo that cannot be improved on and other times the tattoo is completely gone. Your results will be somewhere in that range.
Most patients will require 6 to 10+ treatments depending on the above factors. Keep in mind that each patient is different and some patient to patient variation in response does exist.
Treatments should be spaced at least 8 weeks apart to allow sufficient time for the cellular garbage crew to absorb the disrupted ink. Any sooner would be a waste of time and money. Waiting longer is actually better and if time is not an issue, it is better to wait up to 4 months.
High performance laser systems such as those we use have made laser tattoo removal very safe. Nevertheless there is a risk of complications whenever laser treatment is performed. These include but are not limited to: blistering, prolonged irritation, hyperpigmentation (spots of darkened skin), hypopigmentation (spots of lightened skin), and burns. Allergic reactions can occur after treatment of certain metallic dyes. Again, these complications are rare and even if they do occur, they typically resolve in a few days to several months. It is extremely rare to have true scarring after laser tattoo removal although there is occasionally slight texture change which is typically due to the tattooing not the laser treatment.
Yes. We are excited to be able to offer laser tattoo removal to just about all skin types.
Technically it is safe to treat a pregnant patient. At Senza we do not treat pregnant patients.
Tanning and lasers do not mix. Your risk of complication is increased substantially if you are tanned or are exposed to sun/tanning booth around treatment time. We sometimes treat mildly tanned skin for patients who accept the additional risk but we recommend no exposure for 2 weeks before and after treatment.
Yes. Some patients have a better pain tolerance than others, but to be honest, you will look forward to the results not the treatments. We have anesthetic (numbing) cream for certain sensitive areas which can be topically applied before your treatment and does a great job of making the treatment more comfortable. Other options are to inject the area with anesthetic at an additional cost or on the budget side is an ice pack. The good news is that the treatments are typically fast from as little as 10 seconds to a few minutes depending on the size of the tattoo.
You will be able to resume your normal daily activity after laser tattoo removal. The treated area will need a few weeks to heal.
The treated area will initially turn white then red along with sometimes considerable swelling. Some areas can develop a blister especially areas with red/green ink. The tattoo will sting for a few hours and will be sore to the touch for a few weeks.
The best way to determine how good a candidate you are is to schedule a consultation with us. We will assess your individual needs and develop an appropriate treatment plan.
Titan Skin Tightening Technology is a nonablative, nonsurgical lifting procedure which causes the collagen in the dermis to contract and tighten. It is not a laser but it does employ infrared light to lift and tighten the skin so that gravity changes are softened, fine wrinkles are less obvious and pores are shrunk.
The hand piece of the Titan is applied to the skin. The tip of the hand piece has a device for cooling the top layers of the skin to protect the epidermis from damage. The Titan sends infrared light through the protected top layers of the skin into the deeper layers of the skin causing tightening of the collagen architecture. Because the heat is applied deep within the skin, some swelling and redness may be seen. The procedure takes approximately one hour.
The Titan can be used for tightening skin over various areas of the body including the forehead, the lower face along the chin line, under the eyes, the hands, the abdomen, around the knees, arms and around the elbows.
Some patients see subtle results within a couple of weeks of the treatment, however, for most patients the results gradually appear over a three to six month period. This is probably the most difficult part of this procedure as the effects of the treatment are not seen immediately. Patience and realistic expectations are required. People respond differently to this type of treatment. Evidence from older technology using radio wave frequency suggests that 1/3 of patients do very well, 1/3 have positive but not dramatic results, and in the other third the treatments simply do not show signs of improvement.
The advantage of the Titan over other thermal lifting techniques is that the skin and underlying fat is heated uniformly avoiding differential heating of the fat; therefore, the risk of dents and atrophy of the skin is much less likely.
The Titan Skin Tightening Technology is safe. As with any treatment of the skin, potential complications can occur. Complications such as scar, pigment irregularity, nerve damage, indentations and burns are possible, although rare.
The best way to determine how good a candidate you are is to schedule a consultation with us. We will assess your individual needs and develop an appropriate treatment plan.
Varicose veins--which afflict 10% to 20% of all adults --are swollen, twisted, blue veins that are close to the surface of the skin. Because valves in them are damaged, they hold more blood at higher pressure than normal. That forces fluid into the surrounding tissue, making the affected leg swell and feel heavy.
Unsightly and uncomfortable, varicose leg veins can promote swelling in the ankles and feet and itching of the skin. They may occur in almost any part of the leg but are most often seen in the back of the calf or on the inside of the leg between the groin and the ankle. Left untreated, patient symptoms are likely to worsen with some possibly leading to venous ulceration.
The normal function of leg veins - both the deep veins in the leg and the superficial veins - is to carry blood back to the heart. During walking, for instance, the calf muscle acts as a pump, contracting veins and forcing blood back to the heart.
To prevent blood from flowing in the wrong direction, veins have numerous valves. If the valves fail (a cause of venous reflux), blood flows back into superficial veins and back down the leg. This results in veins enlarging and becoming varicose. The process is like blowing air into a balloon without letting the air flow out again- the balloon swells.
To succeed, treatment must stop this reverse flow at the highest site or sites of valve failure. In the legs, veins close to the surface of the skin drain into larger veins, such as the saphenous vein, which run up to the groin. Damaged valves in the saphenous vein are often the cause of reversed blood flow back down into the surface veins.
Gravity is the culprit. The distance from the feet to the heart is the furthest blood has to travel in the body. Consequently, those vessels experience a great deal of pressure. If vein valves can't handle it, the backflow of blood can cause the surface veins to become swollen and distorted.
Conditions contributing to varicose veins include genetics, obesity, pregnancy, hormonal changes at menopause, work or hobbies requiring extended standing, and past vein diseases such as thrombophlebitis (i.e. inflammation of a vein as a blood clot forms.) Women suffer from varicose veins more than men, and the incidence increases to 50% of people over age 50.
Varicose veins may ache, and feet and ankles may swell towards day's end, especially in hot weather. Varicose veins can get sore and inflamed, causing redness of the skin around them. In some cases, patients may develop venous ulcerations.
Venous ulcers are areas of the lower leg where the skin has died and exposed the flesh beneath. Ulcers can range from the size of a penny to completely encircling the leg. They are painful, odorous open wounds which weep fluid and can last for months or even years. Most leg ulcers occur when vein disease is left untreated. They are most common among older people but can also affect individuals as young as 18.
ESES (pronounced SS) is an easy way to remember the conservative approach. It stands for Exercise Stockings Elevation and Still. Exercising, wearing compression hose, elevating and resting the legs will not make the veins go away or necessarily prevent them from worsening because the underlying disease (venous reflux) has not been addressed. However, it may provide some symptomatic relief. Weight reduction is also helpful.
If there are inflamed areas or an infection, topical antibiotics may be prescribed. If ulcers develop, medication and dressings should be changed regularly.
There are also potentially longer-term treatment alternatives for visible varicose veins, such as sclerotherapy and phlebectomy.
A chemical injection, such as a saline or detergent solution, is injected into a vein causing it to "spasm" or close up. Other veins then take over its work. This may bring only temporary success and varicose veins frequently recur. It is most effective on smaller surface veins, less than 1-2mm in diameter.
As with sclerotherapy, ambulatory phlebectomy is a surgical procedure for treating surface veins in which multiple small incisions are made along a varicose vein and it is "fished out" of the leg using surgical hooks or forceps. The procedure is done under local or regional anesthesia, in an operating room or an office "procedure room."
If the source of the reverse blood flow is due to damaged valves in the saphenous vein, the vein may be removed by a surgical procedure known as vein stripping. Under general anesthesia, all or part of the vein is tied off and pulled out. The legs are bandaged after the surgery but swelling and bruising may last for weeks.
Closure is used, like vein stripping, to eliminate reverse blood flow in the saphenous vein, but without physically removing the vein, and can be performed without general anesthesia. Like other venous procedures, the Closure procedure involves risks and potential complications. Each patient should consult their doctor to determine whether or not they are a candidate for this procedure, and if their condition presents any special risks. Complications reported in medical literature include numbness or tingling (paresthesia) skin burns, blood clots, temporary tenderness in the treated limb.
In simplest terms, arteries pump oxygen-rich blood FROM the heart, veins return oxygen-depleted blood TO the heart.
Deep leg veins return blood directly to the heart and are in the center of the leg, near the bones. Superficial leg veins are just beneath the skin. They have less support from surrounding muscles and bones than the deep veins and may thus develop an area of weakness in the wall. When ballooning of the vein occurs, the vein becomes varicose. Perforator veins serve as connections between the superficial system and the deep system of leg veins.
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