Category Archives: dermatology

Skin Care Peptides and Vitamin C

Peptides in Obagi Hydrate Luxe

Peptides in Skin Care

Peptides, another hot topic in skin care, signal cells to stimulate collagen and elastin. Peptides are short strings of amino acids which can act as signaling molecules to help slow down visible signs of aging. Obagi Hydrate Luxe is the first and currently the only product at Surgical Artistry which contains peptide technology. Obagi Hydrate Luxe containes two key peptides which reduce the appearance of fine lines and increases skin firmness: Chronoline and Kollaren. This was my attempt to teach and discuss within our Modesto office.

Vitamin C in Skin Care

Vitamin C is used by fibroblasts to make collagen and elastin. Vitamin C is also an antioxidant which has a photoprotective effect by reducing damage to cells and DNA which are caused by oxidation from UV light exposure. Oxidation is also caused by pollutants over time. The vitamin C also protects the sunscreen from oxidative changes caused by UV light. This allows the sunscreen to work with less degradation from ultraviolet light.

Skin care is an integral part of plastic surgery.

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Thank you! Enjoy! Disclaimer: double check the facts, I’m just writing all this off the top of my head. Facts can change over time too.

When to restart Tretinoin after an Obagi Blue Peel Radiance Peel

I got this question today, and it’s a question we address constantly. I thought I’d write about restarting facial topical Tretinoin after a Blue Peel Radiance (Obagi) Peel treatment on the face.

When should I re-start Tretinoin again after I receive a Blue Peel Radiance Peel (Obagi)?

The quick answer is about 6 days to restart your tretinoin, also known as Retin-A (among other names). The range for most patients would be 4-8 days. Some can restart sooner if there wasn’t too much irritation from the Obagi Blue Peel Radiance.

The problem of starting Tretioin too soon after a Blue Peel Radiance is that your skin may become too irritated and uncomfortable.

The same goes for restarting all the other Obagi Nu-Derm skin care products which may have been stopped – such as Exfoderm, Exfoderm Forte.

Everyone’s skin is a little different and every esthetician, doctor, dermatologist, surgeon, nurse has a different plan. My guideline of about 6 days works for us at Surgical Artistry, Modesto. But please consult your own practitioner for their own preferences. Our plastic surgery office is directed by Dr. Tammy Wu, Plastic Surgeon and we are located in Modesto, California. Different locations and different climates on the skin affect these recommendations on returning back to tretinoin use.

Other important aftercare instructions for Obagi Blue Peel Radiance Chemical Peel:

Download the Blue Peel RADIANCE After-care Card here or with the below link.

http://obagi.com/sites/default/files/bluepeel_ttearpad.pdf

The pdf file above will talk about the importance of applying Sunscreen.

When to consider another Blue Peel Radiance Chemical Peel.

One can consider another Blue Peel Radiance chemical peel about 1 month later. Theoretically, one can consider a repeat Blue Peel Radiance as close as 2 weeks apart. The purpose of “stacking” the peels closer together is to continue to get better results. After about a series of 5 peels, the improvement is at it’s maximum, and then the goal is maintenance which may be achieved with continued peels every 2-3 months.

A Recent Botox and Dermal Filler Review for Calvin Lee, MD in Modesto, CA

Botox and Dermal Filler review for Calvin Lee, MD Modesto, CA. November 2013.

The review can be found here: https://plus.google.com/102548094439476506081/about?gl=US&hl=en-US

I have saved other (older) plastic surgery and botox reviews here.

Thank you very much for the Botox and Juvederm and Boletero review. It’s very much appreciated. And I will continue to do my best to improve and live up to those high standards written in these very kind reviews.

www.SurgeryToday.com
(209) 551-1888

Belotero Balance a new Dermal Filler from the makers of Radiesse

BELOTERO

Belotero Balance vs. Juvederm – initial thoughts in Modesto, CA

Today I used two syringes of Belotero Balance and two syringes of Juvederm in today’s line of work. I’m happy to report that Belotero didn’t disappoint. I’ve done many tear troughs before with Juvederm and I’ve always injected deep. For Belotero, I injected more superficially.

For both syringes which I’ve used, I mixed in a small amount of Lidocaine with Epinephrine.

Belotero is a dermal filler which was recently approved by the FDA in December of 2012. Belotero FDA approval.

The Belotero Balance Syringe

This is much smaller and much more ergonoic than their Radiesse syringe also made by Merz.

There was no cracking or splitting of the syringe which I’ve sometimes seen when I attach the Juvederm to my 3 way valve. I could probably get a better connector; however, the three way valve is something that is handy in my office because I use it for vein sclerotherapy in it’s foamed version.

The syringe itself is smaller than the the Juvederm syringe; thus it made it somewhat easier to inject initially where the thumb doesn’t have to stretch out as far. It’s a small advantage for those with small hands – such as me. I think this was done on purpose – to make the syringe shorter.

There were, however, some parts of the syringe that snap off – perhaps this is on purpose. The luer lock itself came off when I first connected it to the 3 way valve. The flanges for the syringe itself also slides off, and when playing with the syringe after injecting the product, the rubber tip of the plunger can also become dislodged. Regardless, these are very minor issues – which mostly arise because I like to fiddle with the syringe itself.

Initial Conclusions on Belotero in my Modesto practice

On injection, it feels smooth, and can be easily molded after injection into the skin. I used one syringe on tear trough and the other syringe on the accordion type lines around the side of the skin. I used a superficial approach to these lines – in attempt to use less product. It seems to work well.

It is on the opposite spectrum of their other product – Radiesse – which is a harder substance. Belotero is very soft and pliable but lacks the intense hardness and lift capacity of Radiesse.

I believe that Belotero has a place in the palette of “paintbrushes” we use in our cosmetic injection craft. But I think that more than one syringe is necessary to fill out fine line wrinkles in faces.

Disclaimer: Much of what is discussed above is considered off-label FDA usage of Belotero and Juvederm Dermal Fillers. More info about my Belotero Dermal Filler practice. Belotero has been mispelled – sometimes as Boletero, Bolotero, Belotora, Belatoro. “Belotero” is the correct spelling. An example of a dermal filler consent form, see an example of the Radiesse consent form.

www.SurgeryToday.com
(209) 551-1888

9 Habits of Highly Successful MD Cosmetic Injectors

My list of 9 habits of “Highly Successful MD Cosmetic Injectors.” I’ve spent the last few months hovering around internationally renown MD Cosmetic Injectors. I participated at a Palette Injectors meeting / training for Level III injectors in Sacramento, and I also at the 2013 Vegas Cosmetic Surgery Meeting.

This is my partial collection of empty Botox bottles.

Here are some success habits I think these great injectors have in common.

1. Most of the MD injectors are the injectors of their practice without delegating to a nurse or PA
2. They are constantly looking for newer and better ways to do things.
3. They are eager to explore new products.
4. They selectively use cannulas for some of their injections.
5. They are very willing to share / talk / publish.
6. They make injections a priority in their practice.
7. They often go back to basics which includes knowing the anatomy, and exploring new anatomical concepts.
8. They are not be afraid to show off their grey hair – but will make some attempt to hide their wrinkles.
9. Most importantly they do not view fillers or Botox as a COMMODITY. In other words, it’s not a Botox per unit price or cost per syringe of Juvederm (the PRODUCTS), rather it’s the injector’s SKILL which is the true value. And this is how they provide the best VALUE – through the best skill and materials.

There are also a great number of amazing Nurse and Physician Assistant injectors. I haven’t had the opportunity to attend sessions and lectures by them (yet – I’d like to see what makes them successful as well, so it’s on my list). All the lectures and meetings and demonstrations that I’ve attended in the past few months were by Surgeons and Dermatologists.

Also, these aren’t necessarily “habits.” It was just a catchy title. These are more like “attributes” or “traits.”

Continuing Medical Education for Calvin Lee, MD, Modesto Surgeon

Lifelong student of Surgery, Medicine, and Health. Surgical Artistry (209) 551-1888