Cosmetic Dermatology

Read articles about cosmetic dermatology, fillers, Botox, light therapies and other new modalities.

The Forehead Flap for Nasal Reconstruction: How We Do It

The forehead flap is a useful technique to reconstruct deep and large nasal defects. It can safely be performed under local anesthesia in an outpatient setting. Advantages of this flap include the fact that it provides an excellent color and texture match to the missing nasal skin.

Plasma Skin Regeneration Technology

Plasma skin regeneration technology uses energy delivered from plasma rather than light or radiofrequency. Plasma skin regeneration technology can be used at varying energies for different depths of effect, from superficial epidermal sloughing to deeper dermal heating.

Chemical Peels

With so many new peel preparations on the market today, the dermatologist must ask himself basic questions concerning the products. The most important question is directed to the medical literature rather than the advertising or marketing campaign so common among marketdriven cosmetic products.

Fractional Laser Treatment for Pigmentation and Texture Improvement

Fractional laser treatment with the 1,550nm erbium fiber laser (Fraxel® Laser, Reliant Technologies) has bridged the gap between the ablative and nonablative laser modalities used to treat the epidermal and dermal signs of skin aging.

Ablative Laser Resurfacing – Postoperative Care

Wound care after laser skin resurfacing is critical for achieving a successful result. The superficial thermal injury created by laser skin resurfacing heals more quickly and with a reduced risk of scarring under occlusion. Effective management techniques can help minimize expected negative effects.

Male Aesthetics

Men are a fast growing segment of the aesthetic industry. This article discusses important gender differences in facial anatomy and behavior that are relevant, as well as the requirement for different injection techniques when using dermal fillers and Botulinum toxins.

Poly-L-Lactic Acid as a Facial Filler

Poly-L-lactic acid is a filler recently approved by the US FDA for the correction of facial lipoatrophy in patients infected with the human immunodeficiency virus (HIV). Currently, poly-L-lactic acid, sold under the brand name Sculptra™ (Dermik), is the only product approved by the FDA specifically for this indication.

Novel Flaps for Lip Reconstruction

Reconstruction of the lips requires careful attention to aesthetic and functional goals. We describe our approach to lip repair and present novel methods to maintain symmetry and function, and optimize cosmetic results.

Lustra®, Lustra-AF® and Alustra™

Hydroquinone has been successfully used to treat hyperpigmentation for many years. Recently, new formulations containing hydroquinone have become available, including Lustra® and Lustra-AF®. These products also contain glycolic acid 2%, an active antioxidant system, and moisturizers.

Current Review of the Alpha-hydroxy Acids

Alpha-hydroxy acids (AHAs) are naturally occurring organic carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. Topical formulations incorporating these acids are now frequently used or prescribed by dermatologists.

Blepharoplasty: Indications, Outcomes, and Patient Counseling

A telltale sign of the aging face is upper eyelid skin redundancy and lower eyelid bags. These changes can contribute to a “tired” appearance. Upper and lower blepharoplasty procedures can correct these processes. By removing skin and muscle, an upper eyelid blepharoplasty can give the eye a larger appearance.

Combining Chin-Jowl Implants With Local Anesthesia Facial Rejuvenation

Mandibular implantation is an outpatient procedure that can be used in combination with other minimally invasive cosmetic interventions. Specifically, silastic chin implants can help create a strong chin and smooth the jawline in carefully selected patients.

Clinical Use of RESTYLANE®

There is no ideal filler, nor will there be a single product that can satisfy all requirements. However, RESTYLANE®, a non-animal, stabilized hyaluronic acid (NASHA, Medicis), is a very versatile augmenting agent. It has been in clinical use for 8 years and experience has shown it to be close to the ideal filler in many respects.

Nonablative Laser and Light Therapy: An Approach to Patient and Device Selection

Nonablative laser and light therapy is a relatively novel modality for the improvement of the visual appearance of photodamaged, scarred, and injured skin. A number of different wavelengths and devices have been purported to be efficacious for the delivery of nonablative therapy.

Face-Lifting: An Overview

Numerous adaptations of face-lift techniques have been devised, and each surgical approach has its own risks and benefits, as well as proponents and detractors. All of the conventionally accepted techniques achieve removal of redundant skin.

Advances in Techniques for Endovenous Ablation of Truncal Veins

The latest techniques for endovenous occlusion, i.e., radiofrequency ablation catheters or endoluminal laser targeting water are our preferred methods for the treatment of saphenous-related varicose veins. Clinical experience with endovenous techniques in more than 1,000 patients shows a high degree of success.

Ciclopirox Nail Lacquer Topical Solution 8%

Ciclopirox nail lacquer 8% (Penlac, Aventis Pharma) was approved by the US FDA in December 1999, as a component of a comprehensive management program, for use in immunocompetent patients who have mild to moderate onychomycosis of the fingers and toes without lunula involvement due to Trichophyton rubrum.

Rejuvenation of the Lip with Injectables

As the range of soft tissue augmentation products proliferates, most will be used (with varying degrees of success) to shape and augment the lip. This review will discuss some of the factors that should be considered prior to injecting a lip with soft tissue augmentation products.

The Use of Lasers for Decorative Tattoo Removal

We present our clinical experience along with literature findings on decorative tattoo removal and the important issues practitioners should consider in the management of tattoos.

Blepharoplasty: Laser or Cold Steel?

Blepharoplasty of the upper and/or lower eyelids can restore a youthful appearance to the aging face. This is a minimally invasive procedure that can be accomplished with little bleeding and a small incision.

Recovery Time After Fat Grafting Procedure

Plastic surgeon Dr. Bryce Cowan explains what expectations patients should have in terms of recovery time. Can patients go right back to work the next day, or run a marathon?

Fat Rebalancing: The New “Facelift”

The fat compartments of the face undergo changes and are responsible for age-related alterations in facial shape. The overlying skin responds to changes in fat in much the same way as a garment clings or sags to the body underneath.

Cosmeceuticals: A Practical Approach

The cosmeceutical industry has undergone phenomenal growth over the past decade. Acquiring a basic knowledge of the major classes of active ingredients that are found in cosmeceuticals will enable healthcare professionals to provide accurate and educational information to consumers.

An Algorithm for the Reconstruction of Complex Facial Defects

Dermatologic surgeons are often faced with the repair of complex facial defects following Mohs micrographic surgery. While the size or absence of critical tissue layers may be daunting, the reconstruction of these complex defects follow similar principles to those for the closure of smaller, simpler defects.

The Surgical Correction of Protuberant Ears

While prominent ears are considered a sign of good fortune in the Far East, Western society looks upon prominent ears in a far less positive manner. Children with prominent ears are often the subjects of verbal and at times physical abuse by their peers, resulting in adverse psychological effects.

Adjunctive Skin Care for Acne (Pharmacist Edition)

Acne is among the most common dermatological disorders seen by dermatologists, affecting approximately 85% of people between the ages of 12 and 24 years. The use of adjunctive cleansers and moisturizers can help mitigate treatment side effects and subsequently enhance therapeutic efficacy.

Dermal Fillers: Ever-Expanding Options For Esthetic Use

Aesthetic volume rejuvenation with dermal fillers continues to be a popular procedure that is sought by a growing number of patients who seek the rounder softer contours attributable to a more youthful appearance. This article will focus on the most popular, time tested, and innovative fillers available today.

Twelve Technical Strategies to the Perfect Surgical Scar

Achieving an excellent surgical result while managing disease can be a daunting task when the basic surgical principles we were all taught have been lost to time and the perpetuation of poor surgical habits that were adopted from others. Here are strategies that can help to improve your scar outcomes.

Face Aging: Decade by Decade

The upper, mid, and lower face all age as we go through the decades. Dr. Bryce Cowan explains how symptoms of aging typically manifest over time.

Limited Breast Reduction by Liposuction

We describe a method for liposuction reduction of female breasts that is safe, efficacious, and associated with high levels of patient satisfaction. Liposuction for breast reduction in women is an appropriate addition to the array of liposuction procedures available to the dermatologic surgeon.

Understanding Facial Aging: Non-Linear Aging Process

Why is it that some people (other people!) seem to age slower? It's not fair! Plastic surgeon Dr. Bryce Cowan explains the complexities and factors that affect the timeline of aging, in the first part of the Science of Facial Aging series.

Update on the Botulinum Neurotoxins

The botulinum neurotoxins (BTX) are an exciting group of therapeutic agents with dramatically expanding clinical indications. The US FDA has approved BOTOX® (BTX-A, Allergan) and Myobloc™ (BTX-B, Elan Pharmaceuticals) for the treatment of cervical dystonia.

Markers of Facial Aging

Plastic surgeon Dr. Bryce Cowan explains the two primary processes that affect facial aging simultaneously - volume loss, and malposition.

Fat Grafting: What is it?

What is fat grafting? Plastic surgeon Dr. Bryce Cowan explains this important rejuvenating options that is used both in restorative surgery (after a trauma) and for cosmetic purposes.

How does Aging of the Face Manifest Itself?

The upper, mid, and lower face all age as we go through the decades. Dr. Bryce Cowan explains how symptoms of aging typically manifest over time.

Fat Grafting and Volume Loss of the Face

At what age do we start losing volume in the face, and in what areas? Plastic surgeon Dr. Bryce Cowan explains the process of volume loss with age, and how it affects the overall appearance of the face, and how fat grafting can help combat these changes.

How Long Do the Grafted Fats Last?

Typically grafted fats are long lasting. In this video Dr. Bryce Cowan explains how long fat grafts last in typical scenarios. The longevity of the grafted cells are one of the key selling points of this procedure.

Treatment Options for Facial Aging

Can you reverse the aging process? Dr. Bryce Cowan gives us the truth about aging, cosmetic surgery, and the difference between non-invasive procedures like Botox/fillers vs cosmetic surgery.

Advantages of Cosmetic Surgery when Treating Aging Face

What are the advantages of cosmetic surgery over soft procedures like Botox and dermal fillers? The main advantage is that cosmetic surgery allows for a more profound and long lasting correction that's not possible with other treatment options.

The Cost of a Fat Grafting Procedure

What is the cost of fat grafting compared to injectable fillers? Plastic surgeon Dr. Bryce Cowan explains that it depends on the timeline, the patient’s age, and what they are looking for. Fat grafting is initially more expensive compared to fillers, but has greater longevity by a wide margin.

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