Dr Michael Persky's Blog

What's New? Facial Cosmetic Surgery 2010 Meeting

nospam@example.com (Dr Persky) — Tue, 27 Jul 2010 19:04:29 -0500

Dr. Persky was privileged to attend and honored to speak at The 6'th Annual Facial Cosmetic Surgery 2010 meeting, an international multi-specialty symposium which gathered over 800 core facial plastic surgery specialists from 23 countries. World leaders in the specialties of Cosmetic Dermatology, Facial Plastic Surgery, Oculoplastic Surgery, and Plastic Surgery gathered in the Las Vegas mid summer desert heat to discuss "hot" topics in their fields.

Dr. Persky shared his nearly 3 year experience with FRACTIONATED CO2 LASER skin rejuvenation (Fraxel repair). Fractionated CO2 laser treatment has become an accepted non-surgical technique of facial rejuvenation.

Dermatology experts Susan Weinkle, MD; Ava Shamban, MD; Wendy Roberts, MD; Hema Sundaram, MD; Phill Werchler, MD; Rebecca Fitzgerald, MD; Mary Lupo, MD; David Goldberg, MD; and Lisa Grunebaum, MD to name a few shared their skin care "pearls" as well as their injection and other rejuvenation techniques.

Every patient should be on a RETINOID (Retinol, Retin-A, Renova, etc.)at night if tolerated for optimal skin tone, color, and texture. Fillers are very popular. Dr. Persky believes that SCULPTRA will become a very popular filler in the next five years. TAZORAC is a wonderful topical for the treatment of acne and pore size.

Non-invasive skin tightening technologies were discussed. Zeltiq looks promising using cold to shrink the fat of love handles and abdominal pooches. Ulthera uses ultra-sound energy to lift the tissues of the forehead, neck, and face. Pelleve` uses radiofrequency (RF) energy for moderate collagen stimulation and lifting of the face. Primaevia uses bipolar radiofrequency to diminish wrinkles. E-Matrix uses sublative RF to rejuvenate darker skin types.

Facelift experts are using fat transfer in nearly all of their lifts to supplement facial volume. Fat transfer to the face is alive and well! The latest Rhinoplasty and Blepharoplasty techniques were shared by world leaders as well.

There are new filling agents that will soon compete with hyaluronic acids such as Juvederm and Restylane. The topical "Botox" Revance looks to be a few years away from hitting the market with promising results on the treatment of "crow's feet" and excessive sweating of the underarms and hands.

That's all the news from Las Vegas, where all of the faculty were great, all of the exhibitors friendly, and all of the children not allowed in the casino (with apologies to Garrison Keillor).

Dr. Persky will be speaking about the use of Fraxel repair in the treatment of acne scarring and skin rejuvenation at the American Academy of Facial Plastic and Reconstructive Surgery Annual Meeting in Boston this September. Until the next update, have a great summer, wear your sunscreen, and be well.

And Art Linkletter Thought Kids Said the Darndest Things

nospam@example.com (Dr Persky) — Tue, 27 Jul 2010 00:22:39 -0500

Art Linkletter's classic 50's television show "Home Party" always ended with Art interviewing young children in the segment "Kids Say the Darndest Things". Having participated in answering facial plastic surgery questions on line for the past few years, I must say that some of our patients ask the "darndest things"!

I have decided to share some of those not so frequently asked questions with my friends here. In the future I will make sincere attempts to limit the entries in this blog catagory to only those LOL questions and answers. Enjoy:

Can i have lots of sex after 2 months rhinoplasty ?

4411anon in Brazil

Michael A. Persky, MD - Los Angeles Facial Plastic SurgeonThis facial plastic surgeon is a member of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the world's largest association of facial plastic and reconstructive surgeons.

Hola,

You also earlier asked about your asymmetrical nose one month after your rhinoplasty. We ask our rhinoplasty patients to avoid full contact sports for at least 3 weeks after rhinoplasty. Those that are playing sports that involve balls are told to be careful not to be hit in their nose with the ball. In your case, it is okay to "have lot's of sex" 2 months after your rhinoplasty, but once again, try to keep the balls from hitting your nose. Good luck on all fronts.

Viva Brazil.

Dr. P

For those of you who would like a few laughs from Mr. Linkletter's show, go to : http://www.youtube.com/watch?v=fCHIM-bGiTI

Our Reputation Part III

nospam@example.com (Dr Persky) — Sun, 25 Jul 2010 23:32:40 -0500

"What shall it profit a man if he gains the whole world but loses his soul"

Jesus

When evaluating new and exciting medical technologies and advances it is essential that we use good science as well as common sense in our evaluations. Unfortunately many highly touted technologies are just that, hype and company generated promotion without proven science or clinical studies to substantiate their claims.

I have just returned from the Facial Cosmetic Surgery 2010 meeting, a meeting well respected for its faculty and its content. Sadly, even at great scientific meetings, valuable time and mental effort is sometimes wasted in separating the truth from the hype.

I have spent the 30 years of my professional life in medicine establishing my reputation, and am not willing to compromise ethical care to my patients based on unethical paid consultant presentations. I will continue to offer my patients only clinically proven, safe, and effective treatments in a caring manner. After all, we should do onto to others as we wish they do unto us.

Be well.

Dr. P

Will You Still Need Me, Will You Still Feed Me When I'm Sixty-Four?

nospam@example.com (Dr Persky) — Wed, 21 Jul 2010 02:25:12 -0500

Ever wonder what you might look like when you are older, or more importantly what your prospective mate may look like when they are 64? The Beatles weren't the only ones to ponder that question. Well, a website called Make Me Old (http://www.makeold.com/php/mmo/default/control.php?nopops=&__utma=219000069.2050413622.1279691368.1279691368.1279691368.1&__utmc=219000069&__utmz=219000069.1279691368.1.1.utmcsr=(direct)|utmccn=(direct)|utmcmd=(none)&&scount=3) will do the aging for you.

What is striking is the loss of volume in the face as it ages. Fortunately, in real life, we can use fillers such as Sculptra, Radiesse, Restylane, Juvederm, and fat to replace volume in the face. The trick is finding the best physician "sculpturer" to accomplish the rejuvenation. Remember, the best plastic surgery is always natural and undectable to fellow shoppers on Rodeo Drive in Beverly Hills. It is okay to "puff" the face naturally, but avoid those Pillsbury Boy aesthetic physicians. Choose your facial cosmetic physician most carefully. Be well.

What's Old, New, and Hot in Facial Plastic Surgery 2010? Part I

nospam@example.com (Dr Persky) — Wed, 21 Jul 2010 01:57:26 -0500

>Hi friends. It has been awhile since I last wrote; hope that your summer is going well.

We traveled to Italy, visiting the Vatican and Michaelango's Sistine Chapel, Bernini's sculptures, and Da Vinci's masterpieces. Michelangelo’s David (1504) in the Uffizi Museum, wow! Wonder what these great masters would be doing if they were facial plastic surgeons today?
They probably would have been in Las Vegas (110 degrees) last week at the Bellagio attending Facial Cosmetic Surgery 2010, a multi-disciplininary meeting of some of today’s master artists in plastic surgery. Many of the world's top leaders in plastic surgery, facial plastic surgery, ophthalmic-plastic surgery, and dermatology shared their knowledge and experience at an incredible meeting.

One of the "hot" topics (full pun intended) this year was fractionated CO2 laser skin rejuvenation. I was privileged to present my nearly 3 year experience with Fraxel repair fractionated CO2 laser. Course chairman Randy Waldman, MD, Ed Cortez, MD, and Waffles Wu, MD put together a faculty that would have kept the great Italian Masters awake with interest (maybe with a few cups of coffee) with their incredible results.

I look forward to sharing what's new in facial plastic surgery with you in the near future, unable to right now as I am preparing for tomorrow's rhinoplasty surgery on my patient, oh, his name?... David. Be well , ciao.

Dr. P

The Secret to Looking Your Best....Puff and Buff (PB)

nospam@example.com (Dr Persky) — Tue, 22 Jun 2010 00:14:01 -0500

The study of youthful, beautiful faces reveals two common findings. A youthful face has adequate volume or fullness, and secondly, the skin appears flawless and well hydrated. With aging, we lose volume from our faces through the loss of fat, bone, and muscle. The skin ages due to loss of underlying support as well as from sun damage. Rejuvenation of the face can be achieved by "puffing and buffing" (PB). I originally referred to the treatment as buffing and puffing (BP), but after the BP Gulf oil disaster thought that PB was more appropriate.

PB is the combination of restoring volume to the face with fillers (Sculptra, Juvederm, Restylane, Radiesse, and fat transfer), and improving skin tone, texture, tightness, and color with lasers and other modalities (Fraxel Dual, restore, repair; O2Intraceutical oxygen infusion facials). The treatment is individualized for each patient. We ask patients to bring photographs of when they were younger and felt that they looked their best. By comparing the photos with their current state, a plan is made to restore their youthful appearance, helping them look their best.

While I am on the subject, for those of you who don't already use one, Buff-puffs are an excellent old fashioned technique of exfoliating you skin and keeping it "buffed" inexpensively at home. Clarisonic is also a great at home treatment for the skin. I guess a little self "buffing" at home won't hurt, but please do not try to "puff" at home on your own, unless it is by putting on a few pounds; pass me the cheesecake please. Be well.

Dr. P

Sculptra: The Many Uses in Rejuvenating the Face

nospam@example.com (Dr Persky) — Mon, 31 May 2010 20:12:53 -0500

Sculptra Aesthetic is FDA approved to treat nasolabial folds (smile lines from the nose to the corner of the lip). Off-label use of Sculptra includes filling hollows in the temple area, building up the upper lateral eyebrow which in turn gives more show to the upper lateral eyelid, adding volume to cheeks and cheek bones, replacing lost volume at the base of the nose and maxilla resulting in elevation and shortening of the upper lip restoring a youthful proportion between the upper and lower lips (1:2 ratio), treating lost volume in the chin, pre-jowl area, and building up the jaw line. Other volume depleted areas of the face can also be treated. A natural lift of the cheeks and jaw line can be achieved in most patients.

It can be used in younger patients who are just beginning to see early signs of aging (loss of volume in the face, early jowls) using a small amount of Sculptra properly placed restores that "no worries face of earlier years". Athletic women and men, as well as those who diet, tend to lose volume in their face which doesn't look as good, healthy, and youthful as the rest of their body. Now dieting and working out does not have to be tempered to keep volume in the face. Sculptra aesthetic can restore volume in the face. Older patients who do not wish to undergo surgical rejuvenation can have a natural rejuvenated appearance with Sculptra aesthetic.

The results are gradual over time. Depending on the individual 1 to 3 (or sometime more) sessions separated by 6 to 10 weeks are used to get "complete" correction. Studies have shown that once completely corrected, 85% of Sculptra Aesthetic patients are still satisfied with their results 26 months later. Though initially slightly more expensive that traditional fillers such as Juvederm, Restylane, and Radiesse, when amortized over the years, the cost of Sculptra aesthetic is much less that those other fillers.

I ask that my patients bring in photos of when they most loved how their face looked in the past. We study their photos together in consultation. After analyzing their photos and face, a customized plan is made to restore their lost volume with Sculptra Aesthetic.

Please feel free to contact me if you have any questions or would like to discuss whether Sculptra Aesthetic will help you achieve a healthier, more youthful appearance. Be well.

A More Comfortable Restylane, Perlane, or Juvederm Experience: Restylane-L and Juvederm -XC

nospam@example.com (Dr Persky) — Tue, 25 May 2010 12:24:48 -0500

Now there is a more comfortable solution for patients who are hesitant to start or maintain their facial filler injection treatments because of perceived discomfort during injection.

Both Juvederm-XC as well as Restylane-L and Perlane-L have "numbing" medicine (lidocaine) mixed in with their product. This results is much less discomfort. Patients are noting a much more pleasant "filler" experience. The pre-mixed with lidocaine syringes are noticeably more comfortable than even those syringes that we have manually mixed with lidocaine in the past.

So much for "No pain, no gain"! Be well.

Zerona Laser, Dr. Persky's Thoughts

nospam@example.com (Dr Persky) — Wed, 05 May 2010 21:54:30 -0500

> Many of my patients, and many more of you out here in internet-land have asked me what my thoughts are regarding Zerona laser treatments. For the past year I have researched Zerona technology (since it came to market). I remember first seeing advertisements for Zerona at The Aesthetic Show in Las Vegas, July 2009. The ads were the first of their kind, pasted on the mirrors in the restroom outside of the lecture conference halls at Caesar's Palace. This was my introduction to the creative marketing efforts of the company behind Zerona. The company has employed Leeza Gibbons as their spokesperson.

Zerona claims that patients lose 3 1/2 inches to 9 inches (from their waist, hips, and thighs) in 2 weeks with 6 every other day 40 minute sessions (20 minutes on the front, 20 minutes on the back). All patients need to do is lay still and let 5 painless laser lights rotate on their skin (some practioners even treat OVER clothing) like a prom night laser light show.

Unfortunately, the science of lasers does not support the Zerona's claims.

As mom always told us, if it "sounds too good to be true, then it usually is". I am afraid that in my opinion as an expert laser surgeon, Zerona's claims are too good to be true. I really wanted Zerona to be the real deal, and offer it to many satisfied patients. At $2000 to $3000 per treatment series, the financial incentives are very attractive. I cannot ethically and in good conscience offer my patients a treatment that is scientifically unsound.

Zerona's 635nm laser cannot penetrate the skin so it cannot have any effect on fat cells. The electron-microsope studies that have shown "microscopic holes in the fat cell membrane and leakage of fat from the cells" were done with the laser DIRECTLY applied to fat cells underneath the skin, with no skin to penetrate. The loss of "inches and pounds", if any, comes from the manditory Curva niacin supplement drink, diet, and exercise that desperate patients must follow (this explains why there is "loss in areas that were not even treated by the laser). The company claims are that the "laser triggers a response in the body that causes the fat cells to communicate, causing a general effect in the entire body". Recall that the laser cannot penetrate through the skin to be able to affect the fat cells.

There have not been any comparative studies looking at results with the use of Curva supplement, diet, and exercise alone versus with the addition of the laser light. Given that the laser cannot penetrate through the skin to have any effect on fat cells, most likely the results will be the same without patients having to waste their time having the Zerona laser lights rotating on their skin.

As for me, when the time comes for my inches to be lost, I will try the "AB Circle Pro" at $199 plus shipping and handling. Their before and after photos looked more impressive than the Zerona photos. A few yoga sessions, honest exercise, and diet will likely help as well. Pass me that scoop of Baskin-Robbins Rocky Road ice cream please. Be well.

Heidi Montag Multiple Plastic Surgeries...Love is the Answer

nospam@example.com (Dr Persky) — Wed, 28 Apr 2010 22:06:33 -0500

Plastic surgeons are frequently asked what they think about 23 year old Heidi Montag's multiple cosmetic surgeries performed last winter by Beverly Hills plastic surgeon Garth Fisher. The best answer to that question was this weeks episode of the reality TV show that launched Heidi to "reality fame", "The Hills" (April 27,2010; http://www.mtv.com/videos/the-hills-season-6-ep-1-put-on-a-happy-face/1637514/playlist.jhtml )

Heidi returns to her family's home in beautiful Crested Butte to see her Mom for the first time since her surgeries. Those surgeries included an eye brow lift, chin reduction, revision rhinoplasty, Botox injections, fat injections to lips, cheeks, and nasolabial folds, otoplasty, breast augmentation, and liposuction of the abdomen, waist, thighs and back...whew!

Heidi’s mother, sister, and step-father disapprove of her "plastic" look and are appalled that she risked her life to have more than 12 hours of elective cosmetic surgery, filmed by the way for yet another possible future reality TV show. Her mother implies that Heidi looked better before her "Octo-Plus" surgeries. Heidi shares her pain from the multiple procedures (unable to chew hamburger without severe pain, probably from her chin reduction), and her childhood insecurities, and the "L.A.-Hollywood 'beauty is everything' spotlight" that led to her obsession with plastic surgery. An obsession that may border on Dysmorphic Body Disorder (DBD).

The big question here is why would a young, beautiful 23 year-old voluntarily submit herself to such drastic body changes in one sitting? Most questions like this can be simply answered by The Beatles song "Love is the Answer". When we don't feel true love, we look for it in "all the wrong places". In Heidi's case, it was obsessing that looking as good or better than the "Barbies" of Beverly Hills, Malibu, and Hollywood, she would find happiness. It is apparent that she has instead found profound sadness. Her sadness is compounded after going through all of these surgeries as well as their long, painful recovery only to meet disapproval from the one person she craves love from the most, her mother.

There are surgical indications for plastic surgical procedures in young patients. A nose too big, breasts too large causing back problems, ears protruding to comments like, "Hey, your cab's doors are open" are all legitimate reasons to undergo an elective cosmetic procedure. Expecting the surgery to "change" one's life is unrealistic. You will not be loved any greater; you will not be more popular or happy; it will not get you that dream job or mate.

So what is the moral of the story, what lessons are to be learned? Best to follow the sage lyrics of Christina Aguilera's "Beautiful"(http://www.youtube.com/watch?v=eAfyFTzZDMM). Know that you are truly "beautiful no matter what they say". Be grateful for what you have. Be careful what you wish for, it may not be the answer. Love is the answer.

Fraxel Dual Patient Experience Diary and Photos; What to Expect

nospam@example.com (Dr Persky) — Tue, 20 Apr 2010 12:32:39 -0500

Fraxel Dual laser skin treatments have become one of our most popular treatments with patients who wish to remove brown pigment (age, liver spots) from their face and body with no pain and minimal downtime. The treatment is quick and easy. It can be performed on the face and body as well.

Many patients wish to know what they will look and feel like following Fraxel Dual. To view the Fraxel Dual patient experience diary go to:

http://www.slideshare.net/totalderm/fraxel-re-store-dual-before-afters-pt-diary

Heidi Montag's Breasts, Multiple Surgeries, Dr. Persky in Orange County Register

nospam@example.com (Dr Persky) — Fri, 09 Apr 2010 14:45:11 -0500

Dr. Persky was asked to comment on whether Heidi Montag's recent multiple surgeries and the filming of the surgeries for the use in a future "reality" TV show was common.

In the article published today in the Orange County Register (http://inyourface.freedomblogging.com/2010/04/08/heidi-montag-needs-helium-filled-implants/16499/) Dr. Persky commented when asked about the fact that she cannot jog or hug, "No jogging, hugging, I think that she is leaving out one other important part of life, no schtupping! One upside of her predicament: She won’t have to worry about sex rehabilitation bills [like] Tiger and Jesse’s sex addiction problems. That’s the ‘breast’ that I can do in answering the breast questions.”

“As far as the surgery video, it is not unusual to video celebrity surgery for ‘reality’ television, but as the old wise man in the pizza parlor said loudly to his equally hard of hearing friends when a particularly steamy scene of MTV’s ‘Jersey Shore’ was on the flat screen, ‘Reality? That’s not reality!!!!’

Fraxel Repair, Vogue Magazine Article, "A Facelift, Revisited", Dr. Persky's Thoughts

nospam@example.com (Dr Persky) — Thu, 08 Apr 2010 00:19:09 -0500

Nearly twenty years after recounting her first foray under the knife in the pages of Vogue, author Joan Gage takes stock of what still looks great, what needs a little modern intervention (Fraxel repair), and how times have changed.

Based on my personal experience with Fraxel repair (similar to my esteemed colleague in Massachusetts, Min S. Ahn, M.D. who is the treating facial plastic surgeon featured in this article) since it was unveiled in January 2008, I agree with everything in the article except Daniel C. Baker, M.D.'s opinion that "laser procedures are less enduring and more expensive, in the long run, than surgery."

As the author, Ms. Gage concludes, "But now, a year post-Fraxel (repair), my skin is still free of discoloration and has fewer and less obvious fine lines; the pull lines on my jaw are entirely gone, and the eyelid scars (from previous blepharoplasty) are almost invisible....All in all, I'm pleased with the result which has left my husband (who's a year older than I am) gallantly smiling when he gets comments about his "much younger" wife."

Fraxel repair is an excellent treatment for patients who have had facelift surgery in the past, and do not wish to undergo surgery again.

You can read the entire article featuring Fraxel repair laser skin rejuvenation in Vogue April 2010, or contact my office, we will be happy to send you a copy. Be well.

Reality? Camp Ronald McDonald

nospam@example.com (Dr Persky) — Thu, 08 Apr 2010 00:08:48 -0500

What is reality? We hear so much about "reality" TV. In fact today I was asked by a news journalist to comment about reality TV's Heidi Montag's recent most publicized multiple marathon plastic surgeries. Is it common to video surgeries (her's were filmed) for possible use in a future "reality" TV show? Not "common", and certainly NOT reality!

Later, the same day, I met 10 year old Grayson's mom. She told me about her real life hero. Grayson was diagnosed at age 6 with an inoperable brain tumor. Sorry Heidi, but this IS reality!!!!!

Grayson's dream is to be among the top fundraising teams in this Sunday, April 11'th "Walk for Kids 2010" at Universal Studios backlot (as well as at Victoria Gardens, Rancho Cucmonga and Honda Center, Anaheim). Grayson will be walking 5K, no easy task for him.

In Grayson's words, "My name is Grayson, and I am raising money for Camp Ronald McDonald by walking 5K and getting sponsors to participate. I love going to Camp Ronald McDonald and want to make sure all kids have the same opportunity. you can read my story at www.amazinggray.org"

To donate online, go to www.amazinggray.org, click on "Support Us", and then click on "Team Amazing Gray (blue ink)".

Though the Walk will be over in a few days, I plan to leave this here for good, hopefully so that we can be reminded of true reality, and where to direct our energies.

In these days of "conspicuous consumption" as discussed by author and blogger Seth Godin (http://sethgodin.typepad.com/seths_blog/2010/04/revisiting-conspicuous-consumption.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+typepad%2Fsethsmainblog+%28Seth%27s+Blog%29), please consider supporting Grayson's team "Gray Dragon", and Camp Ronald McDonald. Thank you!

Grayson you will always be in our prayers.

The Secret of Youthful Skin 2010, Dr. Persky's Thoughts

nospam@example.com (Dr Persky) — Sat, 03 Apr 2010 21:49:56 -0500

Our family spent a few days this spring in Sun Valley, Idaho. The time away from my practice gave me the inspiration to share my thoughts about "The Secret of Youthful Skin" with you. First a little about Sun Valley and its charming ski town Ketchum, Idaho.

Sun Valley takes some time to get to, which has made it attractive to the "Hollywood In-Crowd” since it opened as America's first ski resort in the late 1930's. Early on it took planes, trains, and automobiles to get to Shangri-la, as it was nick-named. Nowadays, just a flight into Boise, Idaho followed by a 130 mile drive (or a direct flight into an airport that may or may not be open depending on weather conditions) will get you there.
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Ernest "Papa" Hemingway made Ketchum one of his three homes along with his others in Cuba, and Key West, Florida. He spent his mornings writing, and afternoons fishing and hunting. He loved spending time with actor Gary Cooper, making somewhat of an odd couple. Hemingway took his life (7/2/60) in Ketchum after electro-convulsive shock therapy (for a depressive disorder) caused him to lose his long-term memory; okay for a goldfish, not okay for a prodigious writer. He is buried in Ketchum.

The Kennedys, Lucille Ball, the Schwarzenegger’s, most of old Hollywood, and many Olympic winning ice skaters (Hamill, Flemming, Kerrigan) and skiers (Killy, Stein-Ericksen) have stayed at the Sun Valley Resort. Comedian and social commenter Dennis Miller was at Ciro's (quaint, informal Italian with killer breadsticks...do not visit if you are observing Passover as the temptation may be too great) our first evening in Sun Valley. Though we were very much wanting to hear Mr. Miller's opinion of Obama care, and the latest of addictions, Tiger and Jesse James' "sex" addiction, we respected Dennis and his family's privacy.

Many of the kind and friendly folk in Sun Valley sport serious unabashedly tanned skin. Which finally brings us to the first hint to the secret of youthful skin...pass me the sun block please. The one product that does the most for your skin is an excellent sun block. In our practice we recommend Elta-MD, Ti-Silc, and SkinMedica sun block.

Besides sun block, growth factors, anti-oxidants, peptides, and skin lightening products aide in anti-aging.

SkinMedica products (TNS Recovery and TNS Essential Serum) contain the highest concentration of growth factors (93% versus 2% in its closest competitors). SkinMedica products were the brainchild of world famous dermatologist Richard Fitzpatrick, MD (of the Fitzpatrick skin type I to VI fame). I am impressed with the science behind SkinMedica products as well as their effectiveness. 95% of patients who use TNS daily for 90 days continue to use the product due to improved skin tightness, color, tone, texture, and less wrinkles.

I now recommend TNS Essential Serum to all of my patients (surgical, laser, filler, etc.) as it helps their skin look as good as possible. SkinMedica Dermal Repair moisturizer and Eye Repair are added after TNS. Using sun block during the day and a retinol before bedtime is essential to youthful skin.

Hydration of the skin completes the secret to youthful skin. O2 Intraceuticals hyperbaric oxygen therapy results in refreshed, hydrated skin. Jennifer Anniston, Angelina Jolie, and Madonna have popularized this new technology. Our practice has recently begun using this very popular and effective treatment.
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Lastly, all of your hard work to keep your skin glowingly youthful will be for naught if you get off the chair lift at Sun Valley in spring white-out snow storm conditions, mistakenly turn onto the black diamond Upper River Run (which you thought was an easy, safe green run) with steep, large icy packed moguls covered with 2 feet of new powder snow, resulting in disorientation, vertigo, and a fearful sense of impending doom from an avalanche.

Fortunately I survived to share a bit of our trip to Sun Valley and much about the secret of youthful skin with you. Be well, and enjoy the beauty of life.