Monthly Archives: July 2013

Experienced Botox and Juvederm Injectors Meeting in Sacramento

Botox Master
Picture of myself and Dr. Yoelin, the Botox
Master of San Diego

Botox injectors meeting

I think in this world the word meeting, course, and program are used interchangeably.

There was a course offering from a prestigious injection course which is offered in various places nationwide.  It’s called the Palette Training program for cosmetic injections – and there are several meetings for different levels of injectors and also specialty sections for things such as tear troughs, cannulas and I believe lip augmentation.  There happened to be a higher level course offered in Sacramento.  Not too far from my location of Modesto, CA.

Botox, Xeomin, Dysport, Juvederm, Perlane, Restylane, Belotero, Radiesse

The word is neuromodulators – which includes Botox, Xeomin, and Dysport.  It’s less brand specific.  This was a 4 hour long CME program (I earn credits for continuing medical education).  The program I selected was led by Dr. Steve Yoelin of San Diego.  He has a super busy Botox and Juvederm (I mean neuromodulator and filler) practice which I’ve heard is booked for many years.  I met him before at the Allergan / Latisse speaker’s training program – this was a training session which guided us through the slide deck for our talks.  I was very impressed by him – he was very supportive which I felt made him the perfect teacher.  While I was on “tour” with my talk for Allergan, I met attendees of my talk who spoke very highly of learning from Dr. Yoelin.  So I figured that I should check this course out for myself.  He teaches all levels of injectors and I selected the highest level which was called a level III course.  I thoroughly enjoyed this course and learned a few tips for my own practice.

Take home pearls on Lip Augmentation and more

I especially appreciated some ideas he gave me for lip augmentation and for filling of temples and lateral eye brow areas.  He did say to use the non-dominant hand to help guide the cannulas in injections.

Another great tip I learned from the Tiger Woods of cosmetic injectors (at my recent trip to Sacramento): While injecting Juvederm, he said I had great control, but would be able to take it to the next level if I used my non-dominant hand more to drive the direction of the cannula (special needle).

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How soon after vein procedure do I see results?

Vein Treatment Center in Modesto, CA

I got this question today and I thought I’d try to answer this question.

How soon after vein procedure do I see results?

It’s actually not an easy question to answer because the results vary and everyone starts with a different starting point.  But even after I see a patient, I still have somewhat of a hard time predicting the point where “results” are seen.  First let me define results as “I’m happy to show off my legs.”  or I can word the question a little differently:

How long after I START vein procedures will I be happy with the BEST reasonable results?

Reasonable results = 90% improvement from baseline.

It might be 6 months later after starting vein treatments and about 3-4 sessions of sclerotherapy (vein injections) and vein laser mixed in, and about $1500 spent. And after sclerotherapy, I don’t want patients to experience vigorous exercise for about 9 days after the procedure.  Stockings after sclerotherapy is a must for those 9 days as well.  But after vein procedures, the after care is easier: no stockings needed, and minimal restrictions on the exercise.

Most patients do fewer than the 3-4 to get the greatest results in 6 months.  Many take their time and do 3-4 procedures over 2 years.  But after each procedure, there may be about a 2-3 month recovery time depending on several factors.  And after each session, I’m hoping for 30-50% improvement.

Cosmetic Vein Procedures and Medical Vein Procedures are different

I perform an ultrasound with duplex to see if there is reflux in some of the slightly deeper veins.  If these veins have reflux, I consider the surface veins as a possible side effect of these veins on the inside.  Most of the time, I believe that insurance covers the treatment of the refluxing veins.  This is usually done via endovenous ablation with laser or radio frequency in the office/surgicenter setting or it can be done with vein stripping at a hospital setting.  I have done laser ablation in my office; however, I’ve stopped taking insurances and if our ultrasound test shows that you have what I called a “medical vein issue” then I’ll make some recommendations for practitioners who take insurance, and after these veins are taken care of.  We can deal with the cosmetic vein issues.  However, about 30-60% of the time, I’ve seen much of the cosmetic vein problems subside after the medical vein problems have been solved or improved upon.

Derma Pen Recommendations

dermapen with logo

For our Modesto Plastic Surgery Practice, I’ve come up with these guidelines.

Derma Pen is a modality for improving:

  • Rosacea
  • Scars
  • Lax Skin
  • UV Damage
  • Stretch marks

Is the DermaPen a New Invention?

before-after-1Yes and No.  The makers of Derma Pen thinks it’s a new invention.  However, I’m an acupuncturist who does cosmetic acupuncture.  This idea of wounding the skin with a needle to cause more collagen growth is not new.  From what I know, this needling concept has been used thousands of years ago in acupuncture.  Most acupuncturists today don’t know the art of cosmetic acupuncture.  It requires additional training.  However, I (Dr. Calvin Lee) was very interested in cosmetic acupuncture because it complements our Modesto Plastic Surgery practice.

But I must say the concept of attaching 11 cosmetic acupuncture needles to the end of a machine is a new concept.  What this can do, I cannot do by hand.  I am simply not patient enough to cover as much ground as this machine can.  Finally after 5000 years, there is an improvement to acupuncture!

The Boston Channel website regarding Cosmetic Acupunture – interviews Dr. Calvin Lee (me)

Derma Pen Rivals Lasers?

Article on Automated Microneedling Rivals Energy-Based Tx

Cost of Derma Pen Procedure:

  • MD model (deeper) of the Derma Pen, not the Aesthetician Model (less deep)
  • Done by a Surgeon who is trained in aesthetic injections for the face, who is also an Acupuncturist who is also trained in Cosmetic Acupuncture (um, that’s me).
  • Includes addition of Kerotinocyte Growth Factors with no additional cost – right where the skin is most absorbent.  Yes, growth factors is another craze in the skin care industry.

$400-$500 per session.  Prices change, please call us for more info.

PRIOR TO DERMA PEN PROCEDURE:

1) Stop Tretinoin/Retin-A x 2 days before procedure
2) Avoid prologned / direct sun exposure or sun burns to the treatment area for 2 days
3) Skin should be clean and makeup free before coming for the procedure
4) We will place numbing cream containing Lidocaine 15 minutes before the procedure.

How often can the Derma Pen be done?

ANSWER: You should see an improvement in your skin after the first visit. You can have them as close as once per month. At this time we are recommending, once per month for the first 5 months, the after that possibly every third month to continue to show improvements.

How long does Derma Pen results last?

I’m going to answer this based on what I’ve seen with my Cosmetic Acupuncture practice. With Cosmetic Acupuncture, after about 10 sessions, we have seen patients keep their changes for about 2 years. I think we’ll get to that result after 4 treatments with derma pen. But the reason people keep getting treatments after 4 sessions is that improvements continue on and I think folks would be excited to see the clock turn backwards even more.

Post operative care after DERMA PEN:

1) Stay away from sun exposure x 7 days
2) Wear hat x 7 days (wear as much as you can)
3) Do not wear sun screen x 12 hours (we don’t want this to absorb into your skin)
4) Do not wear make-up x 12 hours
5) Cold sore patients may want to take medication
6) Use your serums: Phyto, B5 Gel, Vitamin C gel right away and daily afterwards to take advantage of the greater penetration after Derma Pen
7) Your skin will be dry and a bit red for the next 2-3 days after the procedure. Moisturize with Phyto, B5 Gel, and/or any other favorite moisture product of yours.

darkerskin-dermapen

Can DermaPen be used for darker skin?

Yes, Derma Pen can be used on skin of all colors.

womanlipsdermapen

 

www.SurgeryToday.com (209) 551-1888

www.SurgeryToday.com
(209) 551-1888

Marker for Botox Injections

Planning Botox injections – drawing on skin

For some patients, a precise Botox mapping is what I’d like to do as a Botox injector for best results.  However there are some challenges:

  • The marker should be easy to wipe off after the Botox injection because we might not want to agitate the location of the Botox liquid which has been injected under the skin (intradermal or intramuscular).
  • The maker should be fresh so that we have a large supply of the markers.
  • The marker should be visible on the skin and perhaps visible on the lips as well.  Although a green marker might show up better than a red marker on the lips for lip augmentation.

One solution comes from Viscot Medical.  www.viscot.com.

They make a pen alled the Dermarker (Derm-Marker) which is an EZ removal ink skin marker.  Alcohol erases it very easily without much rubbing.

I got a chance to buy a container full of these pens and I’ve tried the markings on my own skin at the Las Vegas Cosmetic Surgery Aesthetic Dermatology Conference.  I think this will work well for me and take my injection skills to the next level.

This marker could be used for areas of filler/Juvederm injection as well.  However, these markers would be a bad idea for Tummy Tuck and Breast Augmentation markings because those are larger areas and require a surgical prep which is going to erase these markers.  The same company makes a pen for these cosmetic surgeries, it’s called the XL prep resistant ink surgical marker.

We’re happy to bring these markers with us home to Modesto, CA from the Las Vegas meeting.