Move over Botox and Dysport. There's a new
botulinum on the market. Incobotulinumtoxin A, or Xeomin, is the latest
serotype A botulinum toxin available. Manufactured by Merz Aesthetics, it
has been used in Europe since 2008 with over 84,000 patients treated to date
worldwide. Xeomin was originally FDA approved in the US for the treatment
of cervical dystonia and blepharospasm in 2010. It was not until July 2011
that Xeomin was approved for the cosmetic treatment of moderate to severe
glabellar (frown) lines.
What sets Xeomin apart from its competition is that it
contains no binding proteins, giving it the nickname "naked" neurotoxin. In
this "naked" neurotoxin complex, the therapeutic or active component is
isolated and the surrounding ancillary proteins are removed. This
formulation yields high biologic activity and low protein load which could mean
less risk of the body developing antibodies against the product.
Such proteins may also have the potential to limit the
neurotoxin's effectiveness and potentially make patients resistant to
neurotoxins. Also in question is if removing the ancillary proteins
affects the diffusion factor of the product. Some physicians have concerns
about the spreading of Xeomin within tissue as it contains no proteins to
protect the stability around the active molecule.
Although the units between Botox and Xeomin appear
identical, they are not bioequivalent and therefore units of each are not
interchangeable. This will likely further be determined as it is used by
more providers and a certain comfort level with the product and efficacious
dosing is established. Xeomin does not require refrigeration prior to
reconstitution unlike all other botulinum toxins currently on the market. This
could lend to easier distribution as well as ensuring proper maintenance of
temperature and thus efficacy of the product.
What does this new addition mean for the world of
aesthetics? By having more options to choose from, competition among
manufacturers will increase and likely bring costs down. I don't hear
patients or providers complaining!
Among Xeomin are other botulinum toxin products which
are either under clinical investigation or currently seeking FDA approval. Such
agents to look out for include: Reloxin (a purified version of
Dysport, manufactured by Medicis) and Purtox (manufactured by Mentor). With
limited cosmetic data and provider experience with Xeomin, much remains to be
seen how it will fare in the aesthetics market. One thing is certain, as
the most popular cosmetic procedure in the world, we are sure to hear a lot
more about Xeomin and these other botolinums in the near future.
Intense pulsed light - photorejuvenation - has been around
for over 20 years. It has grown rapidly
in popularity over the last decade.
It is the most popular non-ablative skin rejuvenation
treatment that has continued to show clinical improvement of skin quality with
little to no downtime, hence the name "Fotofacial."
With a series of treatments, patients can experience the
Healthier, smoother skin
Reduced redness and flushing
Reduced pore size
Reduced fine lines and wrinkles
Reduced sun damage
A more youthful look
More even skin tone
Increased collagen bundles
Recently a pilot study conducted by Anne Lynn S. Chang M.D.
et al. showed evidence of rejuvenation
at the genetic level. "Rejuvenation of Gene Expression Pattern of Aged Human
Skin by Broadband Light Treatment" is published in the Journal of Investigative Dermatology (2013) 133, 394-402;
doi:10.1038/jid.2012.287; published online 30 August 2012.
were treated with a series of 3 treatments on the forearm of broadband light
(BBL), 4 weeks apart. Skin biopsies used to obtain genetic material were taken
from the participant's treated area and a variety of comparisons were made to
the adjacent non-treated area.
The researchers used gene-sequencing technology to examine
the effects of BBL on skin aging. BBL is also known as IPL - Intense Pulse
Light or photo rejuvenation. They found that skin aging was associated with a
significantly altered gene expression level, which became "rejuvenated" after a
series of BBL treatments. The skin biopsies taken from the areas treated with
BBL showed gene expression level more similar to youthful skin.
This gives us a better understanding of what
happens on the molecular level of skin rejuvenation using broadband light (BBL, IPL). A series of photorejuvenation
treatments can restore the gene expression pattern of skin aged due to intrinsic
genetics or environmental factors and will then resemble younger skin.
sequencing is new technology that will continue to help researchers learn more
about the aging process of human skin and can now be used to show the miracle
transformation of skin using Intense Pulsed Light - hotorejuvention.
Vivatia is an advanced skin care system offering
patients undeniable results. This system is a new take on anti-aging skin care,
focusing on safe and effective delivery of key ingredients such as
anti-oxidants and hydroquinone.
Vivatia consists of 3 steps:
Gentle Cream Cleanser - A non-foaming cream cleanser that is hydrating while it
cleanses to remove impurities. It is specially designed for use with
high-potency retinoid therapy that we all know causes cell turnover (peeling) and
in patients' eyes "dryness." To calm the skin this cleanser contains
green tea, aloe vera and chamomile.
Active Repair Complex - A unique retinol formula with peptides, vitamins and
antioxidants which help to reduce the appearance of fine lines and wrinkles for
more radiant, younger-looking skin. This product is available in 0.5%, 0.75%,
1.0% pure retinol concentrations. It is recommended that patients start at 0.5%
and work up.
Brightening Coplex - This formulation combines 10 powerful brightening agents to
help even skin tone and fade dark spots. Included in this complex is 2%
hydroquinone, as well as niacinamide, whitonyl (palmaria palamata extract),
kojic acid, licorice root and arbutin.
How is Vivatia different from other anti-aging
products? Well for starters, Vivatia utilizes the proprietary foam
delivery of retinol - making the product "tough on aging" yet "gentle on
skin." Unlike some harsh products that make patients red and have unwanted
peeling, this system does the job with little irritation.
I love this because patients will really see
results with minimal redness or peeling that interferes with their busy life
style. We also love that with proper sun protection, this product is safe
for those who enjoy outdoor activities. Also, this product contains a
formulation of low dose hydroquinone (2%) that is safe to use year round.
I am a firm believer in treatment options for
patients. Many have tried everything and they will come to you
wanting something new and improved. In my opinion this is a
great topical treatment. I always encourage patients to understand that proper
skin care is not just achieved by a peel or laser treatment (especially for stubborn
conditions like melasma). While in-office treatments can greatly
enhance home care, using the right products consistently at home is a necessity
for glowing, happy skin.
Earlier this month I
discussed using a combination of over-the-counter and prescription topical solutions
for treatment of acne. In patients with more severe cases of acne, oral
antibiotics and chemical peels may be
used in addition to other treatments. Laser or light therapy may provide
improvement in clearing acne when these other treatments have failed. I highly encourage continuing the use of
topical acne solutions while undergoing laser or light therapy.
It's difficult to predict how
patients will respond to these various treatments. Most see improvement, but
results cannot be guaranteed. Usually, a series of treatments are required. The
following technologies have been successful in our practice.
Acne Light (Omnilux Blue and Red Light)
Blue light is the
most commonly used. It targets P. acnes.
Red light can be
added in the regimen to help reduce the inflammation of acne.
Combining the two has been very
effective for most patients. There is no downtime using either light alone. One
20-minute session of each light per week for 4-8 weeks is recommended.
Photodynamic Therapy (PDT)
A photosensitizing drug such
as ALA - aminolevulenic acid is applied to the skin and left to incubate for
period of 30-60 min. (incubation period may vary in other practices). During
this incubation period, ALA is absorbed by rapidly growing cells such as
precancerous cells and other cancer cells and has recently expanded with great
success in the treatment of acne.
After the incubation period,
the skin is exposed to a light or laser source that activates the chemical
absorbed to destroy P. acnes and will reduce the size and activity of the
sebaceous glands. Patients must be advised to avoid sun exposure for 3 days.
They will experience redness and exfoliation for 3-5 days but will result in
faster resolution of acne.
Coolbreeze/CoolTouch Laser - 1320 nm
PhotoRejuvention - Intense Pulsed Light (IPL)
Spectra Acne Laser Toning - Q-switched Nd:YAG 1064
V-Beam Pulsed Dye Laser - 595nm
Thermage Monopolar Radiofrequency
Patients will experience
reduction of non-inflammatory and inflammatory acne lesions using one or a
combination of the laser and light technologies above combined with their
topical acne regimen. These laser and light treatments have unique qualities
depending on the wavelength and parameters used, but have overlapping benefits.
Most patients notice a marked
improvement in their general skin condition due to collagen stimulation. They
can experience pore size and sebum reduction as well as reduction of redness
and post-inflammatory hyperpigmentation (PIH) from acne inflammation. Using a series of one or a combination of
these laser and light technologies have improved our management of acne and
acne scarring without causing any surface damage.
Return to the ADVANCE for NPs & PAs homepage.
The best care for scars starts immediately. Knowing
the proper care and treatment for potential scarring is important to know before the
damage is done. Among my favorite initial scar treatments is the topical
use of Biocorneum. This silicone based gel acts as an anti-inflammatory,
improves redness of scars and helps to diminish their size and overall noticeability.
For best results it should be applied twice a day and
massaged into the scar tissue softly. Biocorneum is available at physician
offices only, where it is dispensed. Over the counter alternatives, which
can be found in stores or online, include products such as Mederma, Kelocote
and Scar Guard.
While Biocorneum does contain sun protection, I always
recommend a physical sun block be used concurrently. The sun loves to
further accentuate vessels and redness, which we want to decrease in scars, so
protection from the sun is essential.
Scars reach their maturity by about one year. The first
few months are by far the most important. As scars approach 6 months and
on there is less of a chance for improvement. If hyperpigmentation exists
you may need to add a bleaching agent to lighten. Every case is always
unique -- one of the true beauties of aesthetics.
After you've done everything you can with creams, the
best in-office treatments include fractionated lasers (for textural
discrepancies) or lasers which target the redness (for vascular changes). My
approach after good topical care is typically with a combination of
fractionated laser treatments and IPL (Intense Pulse Light) sessions. I
always stress to patients that no treatment removes a scar. If
you make that clear prior to treatment their expectations are much more
realistic and both parties are happier. And as always, start treatment as
soon as possible for best results!
Teens and adults suffer from acne due to hormone
fluctuations and stress. Some feel diet may play a role. These factors
stimulate sebaceous glands that causes the oil production that the P. acne live
on. Most patients have tried a variety of over-the-counter acne remedies before
they get to our clinic.
Acne can range from mild blackheads and whiteheads (comedonal
acne) caused by pores blocked by sebum and skin cells to inflammatory acne that usually
presents with redness and inflammation under blocked pores. The most severe
form of acne is cystic acne. Cystic acne usually is painful related to a deeper
bacterial infection most commonly by propionibacterium acnes. Cystic acne may
lead to disfigurement and result in residual scarring and the goal would be to
treat as soon as possible to avoid further scarring.
Over the Counter
For milder cases of acne, various soaps, washes, toners and
cleansers have been effective. Two of the most common are benzoyl peroxide and
salicylic acid. Benzoyl peroxide acts as an antibacterial treating
propionibacterium acnes. Salicylic acid is a keraolytic agent that softens and
exfoliates the outer layer of skin, the stratum corneum, and helps prevent
clogging of the pores with sebum and skin.
solution can be useful in treating mild comedonal acne. Patients usually do not complain of
irritation with use of this product.
Topical Antibiotics such as clindamycin, erythromycin
and sodium sulfacetamide have been effective against propionibacterium acnes.
Topical Retinoids work to reduce
outbreaks by modulating cell turnover, which prevents inflamed skin cells from
clogging pores. It reduces the frequency and severity of acne breakouts. Side
effects such as increased sensitivity to sunlight, dryness, redness and peeling
need to be discussed. These side effects can be managed to improve compliance
Antibiotic resistance is always of concern. Combining
topical antibiotics with benzoyl peroxide has been one approach to reduce
antibiotic resistance. In addition, combination therapy using clindamycin or
erythromycin with low dose benzoyl peroxide has proven to be more effective
than clindamycin or erythromycin alone, in some studies.
Combining topical retinoids enhance the penetration of
topical antibiotics and improves treatment outcome. Later this month, I will
address added benefits to combination therapy using laser and light
Tired of buying over the counter products that just
don't work? So are patients! One of my passions for what I do is
finding just the fix for someone -- something that will work and improve their
condition. Pharmacy aisles and mall cosmetic counters are now flooded with
an overwhelming quantity of products of varying efficacy.
Let's be honest -- some of these products just don't do
what they claim. These products do not pass through the FDA's approval
process and do not have a high standard of regulation. Cosmeceuticals,
with their indication for use regulated by medical providers, really are in my
opinion a great option and an answer for patients.
Why offer cosmeceuticals in your medical practice? They
are an essential tool for dermatologists and cosmetic specialists. We are
results-driven and patients are also driven by results. Most patients like
the convenience of in-house recommendations rather than attempting to find
products online or over the counter.
In my personal experience, if a patient leaves with a
product, versus the name of one or handed a prescription, they are much more
likely to use the product and therefore improve their condition. Now this
doesn't mean you need to sell every product imaginable. Have
products that you stand by and have proven with experience to work. Write
a prescription when it is the better product for a patient. But don't be afraid
to have it there for them!
Many cosmeceuticals are now available online or even on
an over the counter basis. How can you set your products apart? With
branded products. Branding your own products has been increasing in
popularity as more and more cosmeceuticals are available outside of medical
offices. Many companies offer the option to brand their products with your
company name and logo to dispense. A win-win in my book.
Bottom line: Whether your practice is strictly cosmetic or geared towards more
medical treatments, cosmeceuticals are a great addition and staple to a
thriving practice wanting to offer the very best to patients. From a
business standpoint, if they are not purchasing it from you they are getting it
somewhere else. Why not keep that business at home for a successful and
very happy 2013!
spots may include:
- brown patches
- hyperpigmentation (due to
inflammation or trauma to the skin from acne)
- insect bites
common cause of brown spots or age spots on the face, chest, arms and hands is
sun exposure. Melanocytes produce melanin to protect the skin from the sun's
ultraviolet light; however, sun exposure can cause an excess production of
melanin, leading to unwanted brown spots.
frequently present in our clinic with complaints of unwanted brown spots or
marks on their skin. After carefully taking a patient's history, evaluating the
skin, and ruling out the need to refer to a dermatologist for suspicious
lesions, a variety of brown spot treatment options can be offered. First, the
most important step is prevention with broad-spectrum sunscreens.
Topical bleaching agents such as hydroquinone and kojic
acid, alpha hydroxyl acids and tretinoin may be helpful individually or in
combination in reducing the pigment and may help in reducing the incidence of
PIH (Post-Inflammatory Hyperpigmentation) as a result of treatment for the
brown spots, especially in those with darker skin types.
of laser and light-based technology
has rapidly improved the efficacy and safety of treatment for brown spots.
Laser or light based procedures that can be performed provide little to no
downtime; however, several treatments may be required.
also known as FotoFacial or IPL (Intense Pulse Light), is a light-based
treatment used to break up melanin by reducing surface pigment gradually. Most
devices now have contact cooling which makes the procedure much safer for most
skin types. Laser toning using a Q-switch laser 1064 nm can break up pigment
gradually, be used on all skin types and can be accomplished without giving the
patient any down-time.
nm wavelength for treating brown or age spots provides more rapid results, but requires
social downtime. The laser emits the energy that is absorbed by the melanin and
vaporizes the brown spot. During the procedure the lesion turns from brown to a
grayish color, which develops into a small scab within a few days. After the
scab comes off, the skin is pink initially and usually regains pigmentation
blending with the surrounding skin.
time varies with the location of the body being treated and energy level used.
On the face I have my patients expect 5-6 days of healing. The neck and chest
may take 7-12 days while extremities may take 2-3 weeks. Great caution is
needed when treating skin-types on the Fitzpatrick scale of 4 or greater.
has been controversy with prepping the skin with bleaching agents and tretinoin
pre- and/or post-treatment. I personally encourage pre- and post-treatment in
conjunction with use of a broad-spectrum sunscreen daily post treatment.
Return to the ADVANCE for NPs & PAs homepage.
If your "anti-aging" eyes wander like mine, you are
probably interested in more than just facial rejuvenation. Below the face
and neck we have several very important areas to consider. Take for
example the décolletage.
One concern many patients have is aging of this region-
think wrinkles, sun spots and loss of collagen and elastin within the skin. With
the use of medical grade creams, such as retinol and growth factors, the skin
integrity can be greatly improved. However, these creams do not address the
generalized laxity and crepe-like quality we can see develop in the décolletage
as we age.
One interesting topic I came across more recently is the
use of décolletage "pads." If you were like me when I first heard of the
approach, you are thinking: What did she just say? But really,
these pads do exist, and in fact are a very real and popular treatment modality
for rejuvenation of the chest. Such pads are reusable and washable (often
self-adhesive) that are designed to correct and prevent chest wrinkles caused
by aging and the sun as well as sleeping on your side and stomach.
The pad is worn at bedtime to prevent the
delicate chest skin from forming creases during sleep. There is an array of
products on the market, but most are made of medical grade silicon. So for
patients complaining of those lines that won't disappear with any creams-
consider the décolletage type pad as an addition to their "beauty sleep"
routine. Such a pad could also be considered after a breast augmentation
or reconstructive surgery as the skin may stretch or wrinkle in accommodation
for the increase of size.
One of the more common requests patients come to our clinic
for is treatment of brown spots. As the world of aesthetic laser practices
grow, and more people are aware of laser treatments for skin rejuvenation, the
demand for brown spot removal increases.
Unfortunately, in some aesthetic practices, consultants
without dermatological training are the ones who are recommending various
treatment modalities to patients presenting with brown spots.
Anyone involved in a skin examination should be familiar
with the ABCDs of melanoma detection and know when to refer to a dermatologist.
Asymmetry - Does one half of a mole look different from
Border Irregularity - Is the edge (border) of the mole
ragged, notched or blurred?
Color - Does the mole have a variety of hues and colors
within the same lesion?
Diameter - What is the size of the mole? While melanomas are usually
greater than 6 millimeters (about the size of a pencil eraser) in diameter when
diagnosed, they can be smaller.
increased risk of melanoma include:
- Family history of
- Atypical moles
greater than 6mm
- Fair skin types that
- Have more than 50
- Diagnosed with
- Long history of sun
- Weakened immune
systems caused by disease or immunosuppressive medications
Although I have had
some experience with medical dermatology and performed skin biopsies, if a
patient presents with a brown spot that appears suspicious and different than
other surrounding spots or if he/she reports changes, pruritis or bleeding,
even if it is less than 6mm in diameter, I prefer to refer any suspicious
lesion to a dermatologist.
Know your ABCDs of
melanoma detection and educate patients on sun protection for prevention of
premature aging of the skin and skin cancer.
Trends in aesthetics are evolving to provide patients with less
invasive treatment options. The under-eye region remains a common area of
concern for patients. With age, skin responds more slowly to pulling and its
recoil time lengthens as the integrity of collagen and elastin is compromised.
Research involving the skin integrity in the under-eye region
proved there was something to be done about that and it could be done non-invasively. Thus,
there is a new treatment modality in pre-trial for patients concerned about the all so
common darkness, puffiness and under-eye bags.
The treatment (unnamed until it has FDA clearance) is a completely non-invasive treatment for lower lid
rejuvenation. It is a biomaterial which was created by dermatologists
and biomedical scientists to smooth, tighten and hydrate lax, aging skin. The
material is applied topically with results becoming visible soon after
application (in as little as one hour).
The system works with a two step application process. First,
the contouring complex is applied, which contains the propriety biomaterial. Then
the activator is used to activate the complex to form an invisible,
breathable material that tightens lax skin. The results last throughout
the day with noticeable improvement in puffiness, reduction in bags and fine
lines and wrinkles. Best of all, this is all achieved without surgery.
Benefits of CO2
Fractional Laser Resurfacing TreatmentsThe fractional CO2 laser heats water
within the surface layers of the skin, causing both the water and the tissue of
the skin to turn to vapor. Every time the laser passes over the skin, some of
the outermost layers of the skin are removed in a precise and controlled way to
the appropriate depth.
The skin then heals over a period of time, as new layers of collagen are
produced. The treatment results in an improvement in the appearance of sun
damaged or acne scarred skin. In addition, the post treatment skin will have a
healthy look along with a better texture and tone.
This intensive treatment can significantly reduce the appearance of lines,
wrinkles, and pigment changes on the face, neck and other parts of the body.
The laser can be used to treat delicate areas such as lines around the lips,
eyes and even eyelids or over the whole of the face. Acne and other types of
scars and certain stretch marks can also be improved.
Winter is an ideal time for patients to have laser-resurfacing
procedures performed with less risk of sun exposure following the procedure.
With vacation from work or school schedules, patients can afford more downtime
during the holidays.
Potential CO2 Laser
Resurfacing Side Effects and Complications
Although CO2 fractional resurfacing is a safer alternative
to traditional CO2 resurfacing, it is not without complications. We expect all
our patients to experience some redness and swelling. Depending on the
parameters used and location treated, redness can last 3-21 days. There have
been reported cases of redness lasting up to 3 months. Acne or milia and
hyperpigmentation are the most common side effects we deal with in our clinic. We
have been favoring the fractional CO2 laser over our non-ablative Fraxel
Restore laser due to lower incidents of the acne, milia and
Hyperpigmentation may occur with post laser sun exposure and
more frequently with darker skin types. Despite careful sun precautions some
patients still develop hyperpigmentation. At the opposite end of the spectrum,
hypopigmentation may occur. It's rare,
but usually permanent. Hypertrophic scarring and ectropian, also rare, may occur.
Patients must be given verbal and
written aftercare instructions following their laser treatment. Giving
instructions to them a week prior to treatment is ideal so they can prepare to
have appropriate aftercare products available. Contact dermatitis can occur
when they attempt to use their usual skin regimen or use OTC skin remedies when
their skin is still in the healing process post laser resurfacing treatment.
Among the most important concepts to master prior to
performing neuromodulator injections is to fully understand muscle anatomy in
the region. Below are among the most commonly injected muscles on the head
and neck for cosmetic purposes:
Frontalis: This is the muscle responsible for the horizontal forehead
lines. When this muscle is injected with a neuromodulator it softens the
elevation of the forehead and brows. Too powerful of injections, especially
laterally in the forehead just above the brow, can cause drooping. So caution
must be taken to avoid over correction.
Corrugators: These muscles work together to form the infamous "11s" or
vertical lines in the glabella. Together with the procerus muscle (see
below), the corrugators contribute to the hyper-functional movement between the
brows forming vertical lines.
Depressor Supercilli: These muscles also play a key role in forming vertical
lines in the frown or glabella area.
Orbicularis Oculi: These muscles are responsible for closing the eye and
allow for squinting. This muscle forms crows feet, or the thin horizontal
lines around the eyes.
Procerus: Alongside the corrugators, this muscle lies within the
center of the glabella and is also a contributor to frowning, resulting in
horizontal lines in the glabella.
Platysma: This is the large muscle of the neck which as we age may form very
visible bands and sagging. Injection into this muscle results in a smooth
and lifted neckline.
Nasalis: This muscle is responsible for forming "bunny lines" or
horizontal lines in the glabella and along the sides of the nose.
Orbicularis Oris: This is the muscle around the mouth that may lead
to vertical lines or "lipstick" lines with chronic use or pursing of the lips.
Older patients may complain that they cannot apply lipstick without it running.
Lines caused by this muscle are typically more evident in individuals who
are/were chronic smokers.
Depressor Anguli Oris: Originating at the inferior border of
the mandible at the vertical level of the midpupillary line, this muscle
inserts onto the corner of the mouth, forming lines that may begin to angle the
mouth downward. To subtly elevate the mouth the DAOs may be injected.
It is important to note that lines form
perpendicular to the way the fibers of the muscle run. So as you review
your anatomy book this makes it much more clear where and how the lines are
formed over time. Remember, understanding facial anatomy is essential, but
just as crucial is recognizing the unique anatomy in each individual. Some
patients have very prominent muscles while others may not require as much in
certain areas to soften. No two patients' features or musculature are
identical, so certainly understand facial anatomy, but treat each patient
unique to their needs.
The skin around the eyes is one of the first places that
reveal a person's age. The delicate skin under the eyes that contains less
subcutaneous fat becomes thinner with age. The unsightly age-related changes
include dark circles, "bags" or swelling and puffiness, crepy skin under the
eyes and "crows' feet." Patients often complain that they frequently get comments
that they "look tired."
Every year, millions of dollars are used to conceal dark
circles and wrinkles around the eyes.
Patients can be educated in key ingredients that have been studied to
remedy some of the physiological conditions that create the appearance of dark
circles and wrinkles while improving aging skin.
Heredity is a component in the rate of aging around the
eyes, but external factors that trigger inflammatory processes such as sun
exposure and smoking or irritants can increase production of enzymes that break
down cross-linked collagen fibers in the skin that compromise the flexibility,
strength and thickness of the skin. Dark circles and puffiness may be caused by
poor hemodynamic properties with fine capillaries or reddish-blue blood vessels
that appear more visible under the compromised thin translucent skin.
The appearance of dark circles can be reduced using Dark
Circle Eye Cream, which contains a combination of vitamin K, arnica, a complex
of soy and rice peptides, yeast protein and hyaluronic acid. These products work synergistically to reduce
dark eye circles and puffiness while restoring a youthful tightness to the eye
Patients who still have great fear in the use of neurotoxins
like Botox and Dysport or who want to enhance and prolong their results after
injection of these neuro-toxins can benefit from nature and neuro-chemistry combining
neuro-peptides and active botanicals united to combat wrinkles.
Reduction of crows' feet, frown lines and other dynamic
wrinkles has been shown to occur using a fusion of neuro-peptides and active
botanicals found in Super Peptide Eye Serum which contains high concentrations
of these scientifically proven peptides to boost and extend Botox and
This complex of peptides and botanicals found in Super
Peptide Eye Serum has been shown to reduce wrinkle depth 50%+ while increasing
skin tone (firmer, lifted skin). It has proven to stimulate cellular turnover
creating a more youthful, refreshed appearance.
I recently attended an aesthetics conference in south
Florida. There were many great speakers- seasoned cosmetic surgeons and
dermatologists, successful CEOs, and highly-acclaimed skin care
specialists. Aside from learning about new and improved aesthetic
technologies and techniques, a specific speaker enlightened me before he even
began his lecture.
This particular physician spoke on his experiences with
various cosmetic treatments, but he began his lecture with a simple message: Remember
compassion throughout your career in aesthetics. He shared a few stories
of examples he had experienced in his own career and spoke with such enthusiasm
and emotion behind his words. You could tell this man truly loves what he
does and has a special effect on people.
This hit home for me because in this room filled of
highly educated, although some overly-injected individuals, I think we must never
stop practicing compassion. In a busy world and work day this can easily
get overlooked. We must never become so busy or so concerned with
aesthetics that we forget that compassion plays a large role. In a day
spent nipping and tucking, or simply encouraging at the office, remember that
people elect to undergo cosmetic procedures to look better so
that they feel better. The benefit of some procedures on
an individual's self-esteem can be life changing. Remember that the patient in
front of you is more than a treatment and it is about much more than making
that person look better. It is about the feeling you give them and the
confidence they gain in the process.
Aesthetics could certainly be simply superficial if you
make it just that. However, I am a firm believer that beauty is more than
skin deep. If we practice with compassion, the whole world slows down for
a moment and we make great results even better. We make people feel not
only beautiful but most importantly happy, satisfied, ready to conquer the
world. If a patient no longer looks at a slight imperfection, or even a
more obvious one, and pushes their thoughts towards what they do have going for
them, we have succeeded in aesthetics.
Practicing compassion also includes loving what
you do. I love the rewarding feeling of helping others. I love having
the desire to learn and become better at what I do. If we always practice
with compassion we will reap the benefits just as much as any patients we see. We
must remember that looking our best is about feeling our best and for each
person this is different. Aspire to learn that difference and make a
difference every day. We are very lucky, as I am humbled, to work in our
field and do what we do. As this doctor reminded me and I share with you
today, please always remember compassion.