Stretch marks are caused by rapid physical stretching of the
skin in a condition where elastic fibers due to genetics or hormonal influence.
Stretch marks develop in a variety of circumstances including pregnancy, weight
gain, adolescents with rapid growth spurts, and weightlifters bulking up (usually
on the arms). Men and women can get stretch marks in several areas including
the abdomen, thighs, hips, breasts, upper arms or back. Depending on skin type
and the cause, stretchmarks can appear pink, red, purple, reddish brown, light
or dark brown.
Various prescription and over-the-counter topical solutions
have been recommended over the years with little to very mild improvement used
alone. The following are just a few:
- Wheat germ oil
- Glycolic acid
- Vitamin C
Light and laser devices have given patients more hope. Initially,
treatment was known to be only successful when treatment was initiated while
stretch marks were red or purple, but new laser technology has made it possible
to improve the appearance of stretch marks in their white or silvery phase many
Microdermabrasion and chemical peels have been used for
years with minimal results. Vascular lasers such as the pulse dye laser and
intense pulsed light have been effective in reducing redness or purple
appearance of stretch marks.
Fractionated lasers such as fractional CO2 have now proven
to be effective in improving the appearance of older, silver or white
entrenched stretch marks. Deep fractional micro laser beams vaporize a fraction
of the skin leaving surrounding skin intact which allows for minimal downtime
with reduced risks compared to traditional CO2 lasers. New collagen is produced
in the treated areas resulting in improved elasticity and collagen fiber
Radiofrequency using Viora Refit protocol is something we
have found to be surprisingly effective in improving the appearance of new and
old stretch marks. Radiofrequency heats the tissue and stimulates contraction
and shortening of the collagen fiber bundles causing the skin to appear tighter
and improves the appearance of the stretch marks.
Multiple treatments possibly using different modalities and
topical solutions will be required. The most important part of treating
patients with stretch marks is setting realistic expectations on results and cost.
know aging is a part of life and in many regards, aging is quite fabulous. I
mean, does anyone really want to go back to their high school days? Pimples,
bus stops, getting teased for the outfits we were wearing. I know I personally
would be happy if I never had to look at (or hear about) a yearbook again.
and physically we mature, learn, grow, fall in love, make new friends ... before we
know it, we start to see our skin maturing and looking older. We may like
ourselves better, but we start looking at our skin differently. We experience
our skin becoming dull, less vibrant and less youthful. Collagen, elastin and
hyaluronic acid become less plentiful, resulting in facial lines, wrinkles and
working in aesthetics for many years now, but it wasn't until recently that I
turned thirty. To my teenage cousin I am ancient, to my eighty-something year
old patient I am a baby. One thing is for sure, I finally understand why aesthetic
offices are so busy. We love growing up, but we really don't love the idea of
I see treatments
that work to help facial rejuvenation and treatments that just have false promises.
In many cases, to erase lines and folds we must replace lost structure with
volume. This is not something accomplished overnight with a facial or a fancy
spa day. I have seen this accomplished though, pretty instantaneously, with fillers.
particular that I am gaining more experience with is Radiesse. In the case of
Radiesse, the filler offers immediate and lasting volume. Radiesse is a filler,
or facial volumizer, composed of calcium hydroxylapatite. Like other
fillers, Radiesse acts as a scaffold under the skin, providing structure and
stimulating natural collagen to grow. This collagen production continues
for several months, which extends even beyond the initial effect of
the gel is absorbed and the body metabolizes the CaHA microspheres leaving
behind only your own natural collagen. Results are natural and long lasting -
clinically proven to last a year or more in many patients.
It is a
great choice for building up cheekbones nicely; volumizing deeper nasolabial
folds; augmenting chins and nasal regions. It gives a really nice lifting
effect - especially when patients want filler in the nasolabial area only and
you can show them that by addressing the mid face it will improve the lower
face without a single injection there.
put, this filler can truly rejuvenate your entire face with one simple in-office
procedure. I like my patients and I really like happy patients with incredible
results. We are seeing both with Radiesse.
work with this filler? What other filler or treatments do you do in
combination? We are using it in conjunction with many of the HAs (for more
superficial lines/voluminzing) and it works beautifully. I would love your
You spend hours in the gym doing cardio, firming, toning,
but what do you see in the mirror as you grab another set of weights? Loose, wrinkled,
rippling skin over the tops of your knees. Our skin undergoes several changes
as we age. It becomes thinner, drier and less elastic with the collagen
breakdown. Wrinkles and loose sagging skin become more apparent with time. What
can we do to get that skin to snap back?
Various non-invasive technologies that are well tolerated and
require no downtime can help stimulate collagen production and skin tightening.
The following are popular options:
Causes collagen fibers to shorten, contract and tighten
Alternatives to light and laser procedures that we have
incorporated in our practice are micro-needling with dermapen, which can be
enhanced with Platelet Rich Plasma - PRP (Vampire Facelift).
Cosmeceutical and prescription skin care products used on a
regular basis that have been proven to be effective to reverse the signs of
aging on the face can be used on the knees as well. Prevention with SPF 30-50
containing zinc oxide should be on the top of the list.
I usually recommend antioxidants, human growth factors and
retinoids followed by moisturizers with ingredients that aid the skin in
retaining moisture. In some cases, some patients do well with adding hyaluronic
acid tissue fillers or a bio-activator such as Sculptra.
Patience is required when treating wrinkled, rippled skin
over the knees. It doesn't happen overnight.
It takes about 3 months of "skin fitness" to see any improvement.
It has happened to me before when I am on the other side
of the counter: providers pushing products. I was recently at a
well-known spa, at a very well-known and international hotel. I received a
facial with nice smelling, elegant products. Since I take care of my skin
with medical grade products, I don't feel the need to do frequent facials or
extractions. But everyone loves to get pampered and relax every once in a
So after the completion of the facial, I was brought to
the front desk to check out. The woman there proceeded to show me
products, of which I loved to look at, but had no intention of buying.
I read the ingredients and asked what and why the products
were recommended (she neglected to tell me this prior). After a half-hearted
answer, I told her I would not be taking anything today. She insisted that
the products are what I need after the facial for best results. Only when
I stated that I worked in dermatology did she actually decide to ring me up.
The point of my story is that we should always remember
that educating patients on products, especially in the medical setting, is much
more important than "selling." Pushing products is just bad
Now, if I was a regular at this spa and on a
great skin care routine, I might stock up on their products from time to time. However,
in this case, the products weren't even necessary based on the products I
listed as currently using. It is one thing to show a patient something or
recommend a particular type of product, but pushing is unprofessional and
unnecessary. Always remember what it feels like to be on the other side of
Intense Pulsed Light (IPL) treatments are one of the first
treatments that were introduced to the fast growing aesthetic market. IPL is
used for photorejuvenation and hair removal. A newer term used is Broad Band
Light (BBL), which is virtually the same type of technology. These procedures
are probably the most popular treatments in aesthetic practices today.
Intense Pulsed Light is a very safe tool when used
appropriately, but patient selection is crucial. The risk of burns is higher
with darker skin types, location off-the-face and exposure to natural outdoor
or indoor UV exposure.
Summer time presents as one of the most dangerous seasons to
perform photorejuvenation (IPL) treatments. It's usually a frantic bride-to-be
just a few weeks prior to her wedding who presents to our clinic with a foot
print pattern of redness and blistering on her face, chest or arms.
Surprisingly, most of the cases I have seen are Fitzpatrick
skin type II-III when the settings used were too aggressive and not enough
attention was spent on recent sun exposure history. Oftentimes the practitioner
may ask about the recent sun exposure but may have not specifically inquired
about tanning bed exposure.
Patients are so familiar with IPL that they have presented
to our clinic with the settings that were used on them at another clinic and
request a higher setting to be used. Beware of these patients.
The settings on IPL devices can vary greatly. Newer devices
have added safety features of various cooling methods. If a patient was treated
with an IPL with cooling then goes to another clinic that may have an older
device without cooling, a disaster can occur if the same settings are used.
Patient selection is the most important thing to pay
attention to in avoiding intense burns with these devices. Anyone with recent
sun exposure should automatically be disqualified to have IPL treatment for photorejuvenation
or hair removal.
Realistic expectations must be set. Patients need to
understand that a series of treatments is required for optimal results. Don't
try to be a hero, especially if your patient is getting married in a month.
If you are looking to step up your cosmetic business or
incorporate aesthetics to your office for the first time, in-office
questionnaires are an easy and effective means to field patient interest.
The exact content of questionnaires is completely up to you. They
may be simple or more elaborate for a purely cosmetic office. Since we are
a medical and cosmetic based practice, I find our questionnaires are fair in
that they are not overpowering to those visiting for a medical reason, but
specific enough for our strictly cosmetic patients.
Our questionnaires, for example, ask, "Are there any
additional services you would like to learn more about? Please check all
that apply." We then have boxes with items to check off such as skin care
products, fine lines, facial veins, excess fat, cellulite, thin lips, chemical
peels and hand rejuvenation, just to name a few.
This is a non-intrusive way to inquire as a patient can
simply leave the area blank if that is not a reason for visiting the clinic.
Now, some patients check off everything and those patients you definitely know, even before entering the exam room, have more interest in products and treatments. Meanwhile, such cosmetic questionnaires help us to focus less energy towards cosmetics on the patients who did not check any boxes as their interest.
Keep in mind though, often the people you might least assume would be interested in a cosmetic treatment or product are the ones who very much are. Aesthetics can often surprise you in this sense. Some people may want to do every treatment in the world, yet leave empty handed, while the patient who didn’t express interest on paper leaves with a new skin care regimen and multiple treatments booked.
Our job is not to sell. It is to educate patients on what is available to them and what experience has shown us to work effectively. Results and confidence sell.
We also have a section on our questionnaire that asked patients to rank how concerned they are with their image and how true to their age they feel as though they look. If a patients states they are “not concerned” with how they look, you may want to focus your attention elsewhere.
Again, know that what someone writes on paper may change when they connect with you in the room, so never let a questionnaire dictate your every move. Get a feel for their concerns and give an honest assessment if it is something that they have inquired about or you feel they will truly benefit from.
Quality skincare does not have to come at a steep price. If you splurge in some important areas
(that benefit you the most) you may need to skimp a little in other departments
and that is okay. Let's call this
skincare on a budget, if you will.
- Face Wash: Don't get me wrong. I
love high end, fancy foaming, pretty smelling facial cleanser more than anyone,
but that's not the first place I recommend putting your skincare dollars. I mean seriously, you WASH it OFF. If money isn't a concern there are
ample products to use that will make you feel like you are in a spa every
single day. They will also leave your skin pristine. However, if you
are on a budget, take it easy in this department and you will have more to put
towards a problem area or something your skin really needs kicked up! Also
note that a face wash is not intended to remove eye
makeup. For eye makeup I love OTC cloths that are gentle on the
- Moisturizer: This is
hard because I love some great (ahem, pricey) moisturizers, but there are many very good OTC options that are much more
affordable. For the face, go with
a lotion during the day (with sunblock or layer your favorite sunblock on top)
and if skin is very dry, opt for a thicker cream formulation in the
evening. Shampoo or
Conditioner: While I have come across some really nice ($$) shampoos
and conditioners, there are so many good inexpensive options out there that it
really doesn't make sense to splurge. An idea: pick your favorite shampoo and
go with a less expensive conditioner (or vice versa). Use a more expensive conditioner as a
weekly treatment so it lasts you longer. Remember, you really only need to
condition the midsection and ends -- using too much will bring out excess oil
in the roots and weigh your hair down.
- Sunblock: If you
don't want your eyes to burn, your skin to break out or the dreaded white
"vampire" look, splurge here and you will be happy you did. Opt for mineral based with titanium or
- Make-up: Splurge here
because it is fun and worth it. Using higher end products will allow your
skin to breath and be more radiant. You don't have to go extravagant, but
find products that work well for your skin and are less likely to irritate
you. Start with your foundation or powder (loose mineral is my
preference), blushes and shadows, and then you can always play with OTCs for
mascara, liners or trendy nail polishes.
- Growth Factors: This
splurge is an anti-aging MUST: Gentle
yet effective at stimulating collagen and rejuvenating the skin. The key here
is to use them sparingly to make them last and to use them on the areas you
need them the most. For example,
if you have prominent lines around the eyes, stick to an eye product with growth
factors or an intense, more concentrated serum in that area.
- Facials: Especially
if you need them, they are not a treat but a valuable treatment. Deep pore cleansing with extractions
or a more fun oxygen infused session will rev up your skin so you can continue
keeping it that way at home. Focus
more on an aesthetician that is medically trained over the day spa type
varieties for the best results.
- Travel Size Versions of Your Favorites: Don't use the hotel soap on your face. Just don't. Splurge on great travel size lotions
and washes and you won't suffer on your next trip. Just because you aren't home doesn't
mean you can't take care of your skin properly. If you are traveling to drier climates,
stock up on hydrating agents such as moisturizers or day creams. And of
course, don't forget your travel size SPF!
of my biggest pet peeves is all the promises a lot of the OTCs make and how
glorified "average" products are on commercials. What I've learned in my
time in skincare is that often, spending more on a quality product will cost
you less in the long run (certainly in the peace of mind department) than if
you try numerous over the counters.
Online reviews can be
helpful. Skincare blogs, your dermatologist and even skin savvy friends are
great people to go to for product advice. So if your
aesthetician recommends ten products, try starting with the one or
two you might benefit from the most. Work
them into your current routine and you have an improved skin regimen without
breaking the bank!
We continue to learn about and understand the concept of volume loss in the aging face. We have a wide spectrum of products to use and are learning more advanced techniques to help our patients look more youthful while maintaining a more natural appearance. Patients can now look 10 to 15 years younger with a liquid facelift in just a few minutes.
Although we have come a long way with tissue fillers, there are some challenges when treating areas such as the hollows over the lateral orbital rim, tear troughs and fine lip lines. The lateral orbital hollow would either be ignored or, if treated, may result in unwanted lumps after a superficial injection of hyaluronic acid or another filler. Patients sometimes present with a bluish hue (Tyndall effect) with treatment of tear troughs superficially. Patients treated for upper lip lines with Restylane or Juvederm are usually happy because their lines look better, but they sometimes appear "puffy."
Belotero Balance is a new hyaluronic acid filler with dual cross linking. This allows the product to be soft yet cohesive to inject in the superficial dermis. It allows us the advantage of treating fine lines anywhere on the face, including lip lines, crow's feet, glabellar lines, forehead lines, lines within the cheeks and acne scars, without producing that "puffy" appearance. I feel more confident using it around the lateral orbital hollow with less risk of lumpiness.
Belotero Balance allows me to fine-tune my liquid facelifts or simply address fine lines for patients who opt not to have laser resurfacing and are prepping for a social event.
Okay, okay. Magnifying mirrors may have their
place in the world. But for your skin's sake, please stay as far away from
them as you can! I am a firm believer that more often than not your skin
will improve the less you do to irritate it. When I removed my trusted and
powerfully lit magnifying mirror from my counter a year ago I noticed an
appreciable difference in my skin and the start of healthier skin habits.
See, it doesn't matter how close you look at your pores-
they will always be there. My main problem with magnifying the skin at
home is that people usually do more harm than good. Yes, it will allow you
to see the tiniest of lines, blackheads or vessels, sure. In fact, you
will notice things that really only exist on the reflection of the magnifying
glass. Then, after overly zealous manipulation, you will have worse
problems than a simple comedone. Magnifying the skin, more often than not,
only seems to magnify the problem.
Now, that's not to say that magnifying mirrors don't come
in handy. We all have a stray hair or two that has to go. We all have
eyebrows that need proper maintenance. However, even with eyebrow shaping
I am a firm believer that less is more. Leave more hair there, that is,
and avoid that dreaded over plucked look.
One day they won't grow that readily and you'll be
painting them on instead. My recommendation is to use better light. If
you have great lighting, for example in the car (not while you are driving of
course), you won't need magnification - you will see everything you need to.
Do I own a magnifying mirror you might ask? Yes, I
do. But it is a travel size variety and I put it away every time I use it
in hopes to not use it, or be tempted to do so again, for a very long time.
Safety used to be the first concern patients would have when
they come in for consultations for aesthetic treatments with facial
injectables. Several years ago unsafe practices with unapproved FDA products
had much media attention. Patients are more cautious, do more research and read
online social media reviews prior to their arrival to our clinic.
The most common concern new patients present with now is the
fear of looking overdone or unnatural. Patients usually say they don't want it
to look obvious that they had something done. They can usually name a handful
of people they know who have "had something done." They have described an unnatural
or overdone look as "ducky lips," "trout pout" or "monkey-like" appearance. What
they are seeing is a disproportion - a distortion of balance.
Patient education on facial anatomy with changes in the
skin, bone and fat that occur during the aging process allows them to
understand my global approach to a liquid facelift. I emphasize that my goal is
to give them a more refreshed and rested appearance while keeping balance and
harmony. I invite patients to bring in photos of them 10-30 years younger which
allows me to show them areas of volume loss that they are not aware of.
One of the most challenging areas is the upper lip with deep
vertical lines. Although patients hope to get rid of all the lines, I treat
this area conservatively to avoid distorting the proportions of beauty. When I
treat upper lip vertical lines or enhance the shape or size, I also place some
filler in the lower lip as well to help create balance. Allowing patients to
look in the mirror at various angles, especially profile view, develops a
In an attempt to help meet the patient's goal while maintaining
balance and harmony, sometimes combing injectable fillers with a neurotoxin,
fractional resurfacing or other modalities may be a more optimal approach.
It takes more time to explain and educate patients than it does
to just inject and chase the lines that they are focused on, but when they
understand, they can feel more confident that they wont look overdone or
unnatural - just refreshed.
How do you manage difficult patients? Well, the first thought that
comes to my mind is yoga and meditation. If you are like me,
though, most days there is little to no time for all of that. So a deep breath
will have to suffice.
Dealing with difficult patients in the most professional of
ways is a common obstacle that we encounter in the medical profession and
certainly in aesthetics. By difficult, I am referring to patients who make
our jobs a bit harder, might be a bit demanding, may abuse the time
allotted for a visit, may have an attitude with staff or may do all of the
How often would you say you come across a truly difficult
patient? Fortunately, it is not all that often that a patient is
truly difficult. But when this is the case, how do you handle
the situation and have both parties satisfied with the outcome?
As medical providers, we love questions. We want patients to
ask away -- that doesn't make them difficult. We also don't mind lists -- but
we may mind lists that turn into scrolls. While you don't want any
questions to go unanswered, you may have a patient who abuses the provider's
time in which it affects other patients waiting to be seen.
A difficult patient also does not refer simply to a patient
who is not happy. Some patients may be happy but will
demand different prices or tell providers what they want prescribed.
Sometimes it just takes time, eye contact and proper explanation as to why you
are recommending what you are. You may not see eye to eye but proper
explanation is essential.
Explain risks and benefits properly. Explain options. When
this is done a patient is more likely to realize that the provider
is looking out for their wellbeing, even if the provider's ideas do not
match their own. Make sure clear instructions are given in an
attempt to save time later on with numerous phone calls. If we do the job
right the first time it may take longer but in the end it is much easier than
having to deal with a patient who is not satisfied later.
Question for you: How do you find your medical provider?
The most obvious of answers to this question is our dear
friend, Google. What was life like before this search engine giant? I
don't remember. I mean, seriously, who doesn't google twenty things
throughout the course of the day? The truth is, however, there are many other great
sites specifically dedicated to helping patients find a qualified medical
A newer site that I find to be particularly useful is Zoc
Doc. You can browse the net, shop, order food and now book the next
available appointment with your doctor all within a couple of clicks. This
option saves the often time-consuming step of the phone call. Who likes to
wait on hold, anyway? Man, I wish I had thought of that.
What I also like about sites like Zoc Doc is that all of
the reviews on their site are of confirmed patients. The medical office
must confirm that they were seen before the review is posted. And patients
on the site tend to show the important things that other potential patients
would typically consider in choosing a provider, such as overall impression, quality
of care, wait time, etc. It is not simply a site with positive or negative
feedback from people who are not even confirmed patients.
I think accuracy in reviews helps both patients and
providers who are on the sites - negative feedback (if from a real patient) can
serve to better the practice. This site, unlike some others out there,
seems to represent offices as professional establishments and not simply a
forum for people to rant and rave on their site.
As of right now, there is no way to list non-MD
providers on Zoc Doc. Hmm...I may just have to send this over to them. PAs
and NPs feel free to comment/voice your thoughts on this and maybe we can remind them that we are
valuable players in the world of medicine and if listed under the supervising
physicians could really help patients by providing quality care. All in
all, I am a fan of such sites that provide useful information to patients and
make it easier for them to seek care.
Over the years we have introduced various medical skin care
products and aesthetic procedures such as laser resurfacing, chemical peels and
micro-needling that result in temporary redness, dryness and irritation. At times, instructions for use of moisturizers
for irritation from skin care products or post procedures are not specific enough.
So much time and effort is taken to learn about products that are therapeutic,
and the importance of moisturizers is not given enough attention.
Patients starting on a medical skin care program may not be as
compliant with their regimen if they lack instruction on what moisturizer to
use that when they experience skin irritation and dryness. They either stop
their skin care regimen due to irritation or they fumble on their own through
the local drug stores or the cosmetic counters for products to relieve their
Aquaphor is one of the most common products recommended,
especially after Fraxel or Fractional CO2 laser resurfacing. Frequently,
patients become upset and complain of acne-like breakouts. Breakouts result in
longer downtime than expected post-procedure and require handholding and
Cutagenix is a product that has been well accepted by our
patients who are starting a medical skin care program or post-procedure. Other
practices have used it for various dermatological issues such as radiation
dermatitis. Cutagenix is an emulsion that consists of perfluorodecalin and plant
derived emulsifiers. Emulsifiers surround small droplets of the perfluorodecalin
and create a uniform and stable emulsion. It has the consistency of light
Perfluorodecalin is a biologically inert liquid capable of
dissolving and exchanging oxygen with the environment. Perfluorodecalin, the
key ingredient in Cutagenix, is a biocompatible material that has a high
affinity for oxygen. Skin derives oxygen from the atmosphere. Unlike products
like aquaphor that can create a barrier and inhibit oxygen from reaching the
skin, this highly oxygen permeable emulsion can soothe and calm irritated skin
to breath so it can help restore itself naturally.
Our patients are happier and more comfortable post
procedures. In addition, patients are more compliant with their medical skin
care regimen when they have Cutagenix to soothe the dryness and irritation if
Hyaluronic acid is a basic element in
connective skin tissue. As a hyaluronic acid filler, Belotero is effective
because of its ability to attract and retain water. Hyaluronic acid also
helps to nourish and moisturize the skin. Unfortunately, as we age the
hyaluronic acid in our skin diminishes.
Belotero is a highly anticipated filler and
is unique to all others on the market. It is perfect for rejuvenating
areas such as the frown lines, smile lines, chin folds, Marionette lines (that
give us a sad and tired expression), earlobes and lips and philtrum (commonly
known as smoker's lines).
This filler is excellent for very fine lines
that other common fillers are not able to correct. At our practice, we
love it around the lips for those stubborn "lipstick lines" and
along the eye region. Really, for any superficial or thin line this is a
great product to use in conjunction with other fillers for superior results.
Belotero is natural and therefore it
integrates smoothly into the skin with minimal side effects, such as mild swelling
at sites of injection. Although hyaluronic acid is absorbed by the body
harmlessly in approximately 4-6 months, there are longer lasting results as the
hyaluronic acid retains volume by binding water molecules.
How is Belotero different from other
hyaluronic acids such as Restylane, Perlane and Juvederm?
While chemically all of the
hyaluronic acids are similar, they are very different in structure. Restylane
is composed of small particles. Perlane is similar but has a larger
particle size. Juvederm is manufactured as a smooth gel. Juvederm is
easier (smoother) to inject and causes less tissue irritation.
Please visit http://www.belotero.com/ for more
information on Belotero.
Growth factors enhance the skin's natural ability to
heal and regenerate to produce more youthful skin. Growth factors are
proteins that regulate cellular growth and the activity of skin cells. There
are multiple growth factors responsible in maintaining healthy skin. As we
age, the production of growth factors such as TGFB reduces and contributes to
the development of fine lines and wrinkles.
Years ago, when Skin Medica first developed the TNS Recovery
Complex (Tissue Nutrient Solution), our patients and staff were pleased
with the improvement in their skin quality. Over the years,
various product lines have developed growth factors and we were intrigued with
the newness, packaging and scents of some of them.
As "growth factors" become more popular, we are
often asked, "What is the difference between one product and
another?" Growth factor products vary in type and concentration of these
TNS originates from human fibroblasts and is
blended with antioxidants, cytokines, matrix proteins and a rich
concentration of growth factors in a physiologically balanced preparation
that reduces pigmentation, improves skin texture and reduces the
appearance of fine lines and wrinkles.
After reviewing reproducible clinical studies we
have switched back to the TNS Recovery Complex, which continues
to prove to contain the highest concentration of growth factors (93% concentration) compared
to newer brands that we have carried in
Full strength TNS now combined with advanced peptides, skin-brightening
alpha-arbutin and seven potent antioxidants as one product in two chambers
called TNS Essential Serum. TNS Essential Serum produces an
impressive list of anti-aging results, such as improvement of fine lines
and wrinkles by 44%; reduced age spots, photo damage and
dyspigmentation; enhanced skin tone up to 16%; and enhanced textural
roughness by 89% after twelve weeks of twice daily use. Clinical studies show
that initial results occur in 30 days with optimal results in 90 days.
TNS Essential Serum can be used on all skin types. It can
be applied to the face, neck, décolleté and back
of the hands. It is an ideal product for patients who want to
keep skin care simple, while benefiting from clinically proven