Ask the Doctors

Q: I’d like to be proactive in using good skin care products to slow down the effects of aging, but there are so many products out there. What types of skin care products do you recommend?

A: You should use a daily sunscreen with an SPF of at least 15 to protect against photo-aging and sun damage. You should also consider using anti-oxidants such as Vitamin C and alpha-lipoic acids in the morning. The daily use of anti-oxidants play an important role in the skin’s defense against damage associated with sun exposure. Wearing a nightly Vitamin A cream will help to repair some of the damage that has already occurred, helping reduce sun spots and fine lines and smoothing skin’s texture.

Q: I know that daily use of sunscreen is important, but I’m not sure when to apply it. Do I apply it before or after my moisturizer?

A: You should always apply your moisturizer first. An effective moisturizer should penetrate the skin and lock the moisture inside. Sunscreen should be applied last, as a barrier, and should have an SPF of at least 15. The daily use of a sunscreen with broad-spectrum UVA and UVB protection is an important part of a healthy skin-care regimen. Sunscreens and sun blocks not only protect you against premature aging, they are associated with reducing the possibility of skin cancer. Many moisturizers today contain sunscreens — try to find one that offers multiple benefits related to your skin type. If you don’t like the feeling of liquid sunscreens, you can use a mineral powder alternatively.

Q: I used baby oil to tan when I was a teenager. Now I’m covered with freckles and brown sunspots. Can you recommend a treatment to remove all these freckles?

A: Intense Pulsed Light (IPL) Photorejuvenation will work wonders for all that pigment! This non-invasive treatment selectively targets abnormal changes that come with sun damage like excessive pigmentation. With IPL treatments you are left with the skin colour and texture you were meant to have. There are topical treatment products that help as well. Look for those containing hydroquinone, Vitamin C, Vitamin A acid, azelaic acid and kojic acid. And, from now on, use a sunscreen with an SPF of at least 15 every day!

Q: My face is so red I look permanently sunburned! I’ve been told it’s rosacea, is there way to get rid of it?

A: If you are like millions of people, you may be suffering from rosacea, a skin disorder that causes redness across the nose and cheeks. The red and bumpy look of rosacea is often mistakenly presumed to be alcohol related. Yet rosacea can happen to anyone, and usually worsens with middle age. While there is no cure for rosacea, it is absolutely treatable. There are many ways to improve this condition, starting with a good home care regimen and no downtime treatments such as Intense Pulsed Light. Besides getting the red out, these treatments usually smooth the texture of the skin and result in a brighter more even skin tone.

Q: My face is covered with white marks from the liquid nitrogen treatments I had for early skin cancers. Is there a better treatment now?

A: Don’t feel bad. Liquid nitrogen has been used to burn off early skin cancers for decades, but it can leave white scars. Today, you can choose Photodynamic Therapy (PDT), which doesn’t leave scars. PDT uses a photosensitizing compound called Levulan on the skin and activates it with Intense Pulsed Light and/or a Blu-U light. The Levulan works directly on the early skin cancers, removing them without scarring. As a bonus, the skin feels silky smooth with finer tone and texture. Levulan even targets cancers not yet visible to the naked eye.

Q: What can be done about the dark circles around my eyes? More sleep is not an option!

A: Dark circles around the eyes are usually due to vascular congestion and /or pigment. The skin under the eyes is quite a bit thinner than the rest of the face and as we age, we naturally lose volume. Retinol creams can help to boost collagen and fade pigment. Skin brightening agents can also help address the pigment. These products must be used very carefully as they can cause irritation if used without proper instruction. Other options include the use of lasers to lighten the area, and dermal fillers such as Juvéderm to provide under eye support and youthful fullness.

Q: What treatment do you recommend for adult acne and acne scars?

A: You are not alone – acne affects 80% of the human population. Your family doctor or dermatologist should be able to offer you several options to help get your acne under control. Once the disease is controlled we can customize a treatment plan to help improve acne marks and scarring.

Q: I’ve had microdermabrasion before at a spa, is yours the same?

A: Actually there are many different platforms when it comes to microdermabrasion. We use the Dermasweep MD, which is a wand with light suction and nylon and silk bristles that gently buffs and polishes the skin to achieve a healthy glow. The vacuum suction can be increased depending on patient tolerance for more aggressive blackhead clearance. There is no pain or downtime and the treatment takes about 30 minutes.

Q: I’ve been hearing about ‘cold laser’ and ‘laser facials’ without any heat or downtime – what are the benefits?

A: Lightwave™ LED Therapy is a professional high-powered system that uses up to 3000 high grade red, blue, and infrared LED lights to stimulate collage and elastin production, and tissue repair. It can reduce the visible signs of aging and sun damage as well as part of acne therapy and photodynamic therapy. Professional grade skin care products can be applied prior to the Lightwave™ treatment for better absorption and penetration of active, anti-aging ingredients; this is known as Dermakinetics. There are no risks associated with ‘cold laser’ or Lightwave™ treatments so they’ve become an increasing popular alternative to laser procedures.

Q: I’ve been hearing about the ClearLift™ treatment in the media lately – what can it do for me?

A: The ClearLift™ Laser Skin Resurfacing treatment is a non-ablative laser treatment that heats beneath the surface of the skin without harming the outer layer so you aren’t left with peeling and redness. It’s a quick and painless treatment that can visibly improve textural issues such as pores and minor scarring. It stimulates collagen as well as improves the appearance of brown spots and other sun damage.

Q: I’m noticing that my skin’s texture is changing and I’d like to do something a little stronger, what are my options?

A: The Pixel™ laser is fractional skin resurfacing designed to improve the quality and texture of the skin while it stimulates collagen regeneration. Laser pulses create tiny holes in the skin, which triggers the body’s natural healing process, stimulating the growth of new, healthy tissue. Patients generally experience a few days of mild to moderate redness with some light peeling and flaking. It has been compared to sunburn feeling for a several days.

Q: I’ve been using BOTOX® for several years, and I’ve had a few IPL treatments. The results are fantastic, but my neck is really showing my age, especially the lines. What do you recommend?

A: The skin on the neck can really show a person’s age. The good news is that the same IPL and BOTOX® treatments you’ve used for your face can significantly improve the look and feel of the skin on your neck. Rest assured there are several excellent and complementary collagen-stimulating treatments such as the ClearLift™, Pixel™, Accent XL, Thermage® and Pellevé™.

Q: I have discoloured skin and lines across my neck. Can anything be done about this?

A: The condition you are describing is likely Poikiloderma of Civatte, a red-brown discolouration on the sides and front of the neck. Thankfully, it can be faded with Intense Pulsed Light (IPL) treatments. The lines on the neck that are horizontal are called necklace lines. The vertical lines are platysmal bands and can resemble a turkey’s legs. They will age even the most youthful face. If you want to soften them, you can have BOTOX® injected along the necklace lines or platysmal bands. Of course, a combination of IPL or laser treatments and BOTOX® would give the best overall results.

Q: The Vampire Facelift® has been referenced a lot in the media lately – what is it exactly?

A: The Vampire Facelift® is actually a process known as Platelet Rich Plasma which has been used since the mid-1990’s to aid bone healing and soft tissue repair. Your own platelets are injected into the skin to enhance the healing processes for skin depressions, wrinkles, scarring, fine lines, and collagen depletion. We use highly concentrated platelet rich plasma therapy, which means more platelets than other PRP systems such as Selphyl.

Q: I’m 25 and some of my friends are already getting BOTOX®. They say it’s for preventative measures. Why would someone my age get BOTOX®?

A: BOTOX® therapy is being used by millions as a safe, fast and effective treatment for anti-aging and age-prevention. Deciding if BOTOX® is right for you is an individual decision. Because our skin is elastic, like an elastic band, it wears out over time, producing deep wrinkles from expression lines. BOTOX® targets the muscles responsible for expression lines, reducing their movement for up to four months, making wrinkles less pronounced. With continued use, BOTOX® prevents wrinkles from deepening and helps expression lines from developing into wrinkles.

Q: What about all these new creams that claim to be as effective as BOTOX®?

A: BOTOX® is so effective for reducing wrinkles it’s causing a lot of concern in the skin care industry. So much so, that dozens of companies now compare their products’ anti-aging benefits to BOTOX®. While the use of good skin-care products is an important part of any healthy beauty regime, there is no cream, lotion or potion available today that compares to BOTOX® for effectively reducing wrinkles.

Q: Most of my friends are using BOTOX® and the results are amazing! I’m not worried about immediate side effects, as I know they’re rare. What evidence is there on long-term use?

A: For more than 20 years, doctors have been using BOTOX® with increasing frequency to treat a growing list of medical conditions. It has become the most popular procedure in cosmetic dermatology, and is endorsed by the FDA and health agencies the world over for both medical and cosmetic usage. Millions of people have benefited from BOTOX®‘s therapeutic and cosmetic advantages. No long-term adverse effects have been found. That’s why BOTOX® continues to be the focus of leading-edge medical research, as well as the most increasingly popular cosmetic procedure for eliminating wrinkles.

Q: I’m getting married this summer and I want to try BOTOX® for the ‘brow lift’ effect. How far ahead of my special day should I have the procedure?

A: Fallen brows can leave a person looking tired and old. A lifted brow is a sign of youthfulness and a lateral brow flare can be a sexy, feminizing feature. BOTOX® is the only non-surgical procedure to lift your brow besides radiofrequency tightening options such as Pellevé™. Many of our patients are combining their BOTOX® and Pellevé™ treatments to optimize the lifting and shaping effects of both. We recommend giving yourself 6 to 8 weeks prior to your special event to optimize the smoothening effects. Your brow is the cosmetic center of your face. It deserves special attention.

Q: My girlfriend just had her lips enhanced with Juvéderm™ and BOTOX®. I’ve heard about Juvéderm™ for lips, but why BOTOX®?

A: BOTOX® placed selectively above the upper lip reduces the vertical lines and prevents them from getting deeper. These lines are caused by pursing the lips, which happens in speech. Smoking & using straws makes them worse. Eventually lipstick bleeds into the lines. Small amounts of BOTOX® can also enhance the upturned edge—the vermilion border— to create a pouty look. And using BOTOX® in the lip also helps the effect of dermal fillers such as Juvéderm™ last longer.

Q: I’m interested in treating my excessive sweating with BOTOX®. My cousin had her underarms treated with BOTOX® and now she swears by it. Is it covered by medical?

A: More and more people are turning to BOTOX® as an effective method for controlling excessive sweating of the underarms and palms. Excessive sweating is a medically recognized condition called hyperhidrosis causing both physical and social discomfort. The therapeutic effects of BOTOX® on excess sweating are almost immediate and last up to 6 months, or even longer in some cases. The good news is that most extended health-care insurance programs will cover the cost. The patient need only pay the administering physician the cost of the injection itself.

Q: What are the advantages of using BOTOX® and JUVÉDERM® together?

A: The use of BOTOX® and JUVÉDERM® together has been coined the Soft Lift™ and has been getting a lot of attention in the media for it’s dramatic and non-invasive results. Both procedures are non-surgical and neither requires general anesthesia; the results are seen quickly. The procedures take only a few minutes and the results can be subtle or dramatic depending on your desired outcome. Patients can return to their everyday activities immediately. Neither BOTOX® nor JUVÉDERM®; hamper future cosmetic treatments should a person elect to have other procedures, even plastic surgery, in the future. In fact, many surgeons agree that skin that has been well maintained prior to a surgical face-lift yields a better and more natural result.

Q: What can I do to optimize cosmetic filler results?

A: Dermal fillers like Juvéderm™ and Restylane® do a terrific job of smoothening out lines around the mouth, facial wrinkles, and facial folds. The results are easily enhanced with the addition of BOTOX® treatments. In fact, wrinkles such as frown lines and crows feet respond better with BOTOX® than a filler agent. The combination of the BOTOX® and filler will allow the filler to last longer. Semi-regular maintenance when your schedule and budget permits, prolong the results of filler. To make the most of non-invasive anti-aging skin treatments, you could also include a skin rejuvenating or skin tightening procedure to stimulate collagen.

Q: Everyone says something different, how long will my filler last?

A: Dermal fillers like Juvéderm™ are made from hyaluronic acid. One of the reasons why there are varying responses to this question is because there are many factors to consider such as: the type of filler used, the placement of injection, the area being treated, not to mention the individual patient. When referring to Juvéderm™ we suggest that filler to the cheeks and nasolabial folds will last six months before one might consider adding more. Areas such as the lips may need touch-ups sooner than one year. Many of our patients maintain their results with annual treatments.

Q: Even the most perfectly smooth skin is going to have some wrinkles. What kinds of treatments are available to minimize or eliminate wrinkles?

A: While fine lines and wrinkles cannot be permanently eradicated, there are some excellent choices to minimize and ease that tired older appearance that wrinkles give to the skin. Crows feet, wrinkles round the eyes, furrows on the forehead, tiny lines around the lips and the mouth — these are the complaints we hear most when it comes to wrinkles. Treatments that we recommend and have found to be successful are combinations of BOTOX® and dermal fillers such as Juvéderm™ which can also be added to skin tightening and toning treatments such as Accent XL, Pellevé™, and Thermage® which are the latest advances in non-surgical facial tightening. Treatments such as these combined with a great home care regimen will help aging skin look it’s best.

Q: I’m considering getting a treatment to tighten the skin around my eyes. Do I need to stop the BOTOX® treatments I’ve been having for the lines?

A: BOTOX® therapy is an excellent method for smoothening the lines around the eyes – and there is no conflict with using Thermage®, Accent XL, or Pellevé™. In fact, some patients choose to have both treatments on the same day. Pellevé™ has been especially successful for treating around the eyes and brow to achieve more supple and lifted skin in this area. This frequently results in a more defined upper eyelid crease and a more youthful appearance. Of course, those who treat the whole face can expect to see an improvement in their overall look, not just the eyes.

Q: I have been hearing a lot about a non-surgical facelift. What can you tell me about it and is it available in Canada?

A: The latest procedures in non-surgical facelifts involve the use of radiofrequency energy to tighten loose skin. As it stimulates the skin to produce more collagen, its effects continue to improve over time. We’ve had the most success with Accent XL, Thermage®, and Pellevé™. These treatments have been featured in lots of news segments across Canada and the United States.

Q: Several years ago I tried a non-surgical facelift at a spa. I didn’t notice any difference. So why should I expect any more from the Thermage®, Accent XL, or Pellevé™?

A: With all the cosmetic products and treatments on the market, it is easy to become skeptical about results, especially after a disappointing experience such as yours. By heating up the deep tissues, while cooling and protecting the skin, it is designed to cause immediate collagen contraction followed by new collagen production, which occurs over a period of time. Treatments such as Thermage®, Accent XL, or Pellevé™ are sophisticated and have been proven through clinical trials to tighten skin and provide a more youthful appearance. It is recommended for those who aren’t prepared to have facial surgery, but want to see results that no skin cream or facial can provide.

Q: If there are multiple options for skin tightening, how do I choose which one is right for me?

A: Thermage®, Accent XL, and Pellevé™ are all proven and effective methods for skin tightening and contouring. They each offer a unique and custom method of targeting and delivering radiofrequency energy. For those patients wishing to target the crepey skin around the eyes, under eye bags and even excess skin on the upper eyelids, we will often recommend the Pellevé™ which allows us to get closest to the skin in this area. The Accent XL is a great treatment for targeting not only the face and neck, but also to cover other areas of the body in a relatively short amount of time. We encourage patients to try the different treatments and gauge their response and preferences.

Q: At 48, I’m not prepared to have facial surgery, but I’ve heard I can treat my jowls with Thermage®, Accent XL, or Pellevé™. Do I need to book extra time off work or have any special after-care?

A: Thermage®, Accent XL, and Pellevé™ are non-invasive processes for tightening sagging skin. They are ideal considerations for those who are either not ready or not interested in facial surgery. Some mild redness can be expected, but it doesn’t last long after the treatment. Some people get a bit of swelling and prefer to do the procedure at the end of the week so that they have the weekend off. Other than the use of sunscreen, no specialized after-care is required.

Q: I’ve just learned that there is a non-surgical facelift called Thermage®. No surgery is one thing, but is it safe and is it painful?

A: Thermage® is a well-known, non-invasive method for treating loose skin. Accent XL is another radiofrequency treatment used for skin tightening, which can be done quickly and has been compared by many patients to a warm massage. The Pellevé™ tightening system has a small hand piece that allows us to target the under eyes and brow areas. These treatments are safe, and patients are kept very comfortable throughout. The comprehensive clinical research is well respected in the medical world.

Q: How many Thermage®, Accent XL, or Pellevé™ treatments will I require before I see results?

A: Results are as individual as each person’s skin. These treatments actually stimulate new collagen production, so tightening happens gradually. Studies show measurable tightening happens over a two to six month period following the treatment. Many patients see results sooner and find one session produces the look they want. Whereas some patients may wish to repeat their treatments a few times per year as part of their skin care maintenance regimen. Through consultation, we can identify the right treatment program for you.

Q: I’m a pretty fit person and yet I still have cellulite. Is there anything I can do to improve it?

A: Even the most athletic people can still have cellulite. It’s just the way our bodies store fat pockets. Accent XL is a great way to stimulate skin tightening and firming, which can reduce the appearance of cellulite. Lipodissolve is also an option when it comes to reducing the visible lumps and bumps. An in-person assessment is the best way to determine which treatment is right for you.

Q: I’ve been hearing so much about this new face and body sculpting treatment called Lipodissolve/Mesotherapy“>Lipodissolve or Mesotherapy. What is involved in this procedure?

A: Lipodissolve/Mesotherapy“>Lipodissolve is an innovative cosmetic application of mesotherapy, the practice of injecting small amounts of medication and/or vitamins into the skin. Lipodissolve/Mesotherapy“>Lipodissolve specifically targets localized fat and cellulite deposits and slowly dissolves them with injections of phosphatidylcholine, a fat-dissolving natural substance that is derived from soybean lecithin. It’s the next big thing in cosmetic rejuvenation in North America.

Q: I’ve just learned that there is a new non-surgical alternative to liposuction called Lipodissolve/Mesotherapy“>Lipodissolve/Mesotherapy. How does it compare?

A: Lipodissolve/Mesotherapy“>Lipodissolve is a fast, safe, and less expensive way to reduce unwanted fatty areas. Lipodissolve/Mesotherapy“>Lipodissolve treatments consist of small injections of a natural soybean substance that is highly effective for dissolving the small, stubborn fat deposits that resist diet and exercise. There are no surgical incisions or scarring and no lengthy recovery period as with liposuction. Unlike liposuction, it is very precise, can smooth the skin, and doesn’t involve a general anesthetic or a hospital stay.

Q: A few of my friends have had Lipodissolve/Mesotherapy“>Lipodissolve/Mesotherapy treatments and are thrilled with their results. How many treatments do you need before you notice a difference?

A: For some people, Lipodissolve/Mesotherapy“>Lipodissolve is an excellent method for reducing and eliminating fat deposits that have been resistant to diet and exercise. You can obtain results in usually three to six treatments but since everyone responds differently, the number of treatments depends on the individual.

Q: I’ve heard of CoolSculpting® to freeze unwanted fat but it sounds too good to be true. How does it work?

A: CoolSculpting® is a process known as Cryolipolysis™ which involves freezing the fat cells order to get them to trigger their own cell death known as apoptosis. A percentage of these cells are then naturally eliminated from your body with a gradual reduction appearing over the next several weeks. It’s an increasingly popular body contouring procedure because there is no downtime and patients can resume normal activities immediately.

A: Both options are non-surgical alternatives to liposuction whereby fat is naturally eliminated from the body without any downtime. We typically use Lipodissolve to inject small areas where fat is palpable but not necessarily quite pinchable. We also use Lipodissolve to inject underneath the chin or along the jawline to reduce jowls. CoolSculpting® is beneficial for treating that ‘spare tire’ or ‘love handles’ where you can grab a little handful. We can also treat back or bra fat, upper arms, and upper inner thighs. Basically, as long as the machine can latch onto the area and form a suction seal, we can treat it. An in-person assessment is best to help you determine your treatment plan and what to expect.

Q: I’m considering trying CoolSculpting® or Lipodissolve to reduce some unwanted fat but I’ve heard the fat can come back. Does the slimming effect really last?

A: Treatments such as CoolSculpting® & Lipodissolve injections work well to target small amounts of pinchable fatty tissue. These procedures kill a percentage of fat cells in the treatment area and they are naturally eliminated from the body. Fat cells can be compared to a balloon; they expand when you gain weight and shrink when you lose it. Even when fat is completely removed as with liposuction, patients who don’t eat healthy and exercise are still subject to gain deeper, visceral fat. Therefore the key to long-lasting results is to maintain a healthy diet and exercise!

Q: My friends and I are so sick of shaving and waxing that we got to thinking about Laser Hair Reduction. Is it safe and effective for all skin colours?

A: More and more people are choosing laser hair reduction because of the superb results. Over the years, thousands of people have come to us for laser hair reduction. In fact, ours was the first clinic in Canada to provide the service. And keeping up with technology ensures our patients the best of benefits and safety. We offer sophisticated lasers for hair reduction, each with advantages for different skin types. During your consultation we determine the best laser for your skin type.

Q: I have blonde facial hair. I’ve read that laser hair reduction isn’t effective for treating blonde hair. Is this true?

A: In laser hair reduction, the pulses of light search out pigment, or melanin, to target a hair follicle. Blonde hair contains little melanin, so it is more difficult to treat. For this reason blonde hair often requires more treatments and ongoing maintenance.

Q: What are spider veins?

A: Spider veins are small red, blue, and purple blood vessels that often appear on the face and legs. They look like tree branches or spider webs with short jagged lines. They can be treated with sclerotherapy and/or lasers. Sclerotherapy is a simple procedure whereby the visible veins are injected with a sclerosing solution, which causes them to collapse and fade from view. If this hasn’t worked for you in the past, it may be that you have underlying incompetent veins, which can only be found and treated with ultrasonic mapping.

Before proceeding with any cosmetic procedure, we encourage you to call or contact us with any questions.