Certified Aesthetic Nurse Specialists in Santa Barbara

santa barbara medical spaOne of the things that makes Evolutions stand apart from other medical spas and doctors’ offices is our commitment to education and training.  Our Medical Director and founder, Santa Barbara cosmetic surgeon Dr. Terry Perkins personally and extensively trains all of our nurses and nurse practitioners so that you can be assured you receive the best care possible.

Additionally, we recently sent two of our clinicians (Allison and Sue) back to Florida to attend an aesthetic conference and take the Certified Aesthetic Nurse Specialist (CANS) exam.  The CANS exam is a rigorous test on medical aesthetics only available to nurses who have worked a minimum of 1000 hours in aesthetics over the last 2 years.  There are currently fewer than 20 Certified Aesthetic Nurse Specialists in the state of California, so it is an exclusive group.  We are pleased to announce that both Allison and Sue passed the exam and are now officially Certified Aesthetic Nurse Specialists! Though we have always known how skilled and knowledgeable they both are, this is a great confirmation of that fact!  Congratulations to Allison and Sue!

Book an appointment for Botox, Dysport, or dermal fillers with Allison, Sue, or another Evolutions clinician by calling 805-695-2189.

Santa Barbara Botox Users: Prevent Wrinkles Before They Start

Botox Santa Barbara Evolutions Medical SpaSanta Barbara cosmetic surgeon, Dr. Terry Perkins, and founder of Evolutions Medical & Day Spa, has been an advocate of the use of Botox before many of us even knew about it. In fact, Dr. Perkins was one of 16 doctors selected by the FDA to conduct a study in 1999 of Botox which led to FDA approval of Botox for cosmetic use. Since then Botox has become a very popular treatment for those who want to “erase” their frown and wrinkle lines from their foreheads. However, the latest exciting news is that Botox may also be beneficial in keeping wrinkles at bay. Repeated weakening of the muscles over time can help prevent the wrinkle(s) from forming or from becoming too deep.

To further support this, a study was done on identical twin sisters to evaluate the long term effects of Botox use. One twin received Botox approximately two to three times per year in the forehead and glabellar region (frown lines between the eyebrows) for 13 years. The other twin received Botox only twice over the 13 year study (at years 3 and 7). The results showed that imprinted forehead and glabellar lines were not evident in the twin that was regularly treated with Botox but were evident in the twin that was only treated twice. It was also noted that untreated facial areas (the nasolabial folds – the line that forms from the nose to the corner of the mouth) showed comparable aging in both twins.

Recently an article that was published on “Today Health” cited the twin’s study and also referred to an article by JAMA Dermatology which stated that it is “rarely too early” to start the “conservative and thoughtful use of neuromodulators [i.e., Botox], fillers and noninvasive energy-based treatments.” The article goes on to say that it is not endorsing the use of Botox in children or teens, nor are we, and even the 20s may be too early as well. Signs of aging varies by individual and often will depend on many factors, including a person’s skin type, their genes, and any environmental damage (sun and UV exposure), but normally begins in the 30s for most people.

The best time to start Botox as a preventative treatment to help inhibit the progression of deeper wrinkles would be at the onset of wrinkles (even if they are very mild). At Evolutions Medical & Day Spa, we always offer a complimentary consultation to help our clients individually decide what may be best for them.

Many of our clients feel very fortunate that Botox and Dysport treatments became available to help transform their “look”, literally turning their frown upside down. The next generation of Botox users are even luckier to have the option to prevent wrinkles before they start!

Evolutions Wins “Best Medical Spa” and Announces New Location

The Santa Barbara Independent Readers’ Poll “Best of … 2012” was published on Thursday and we are delighted to announce that Evolutions Medical Spa has won “Best Medical Spa” for the 4th year in a row! We are honored to receive this award and thank you for voting for us!

Santa Barbara cosmetic surgeon Dr. Terry Perkins started Evolutions Medical Spa for clients who wanted medically-advanced, results-driven aesthetic treatments in a “day spa” environment instead of a physician’s office. A sampling of our skin care services include facials, anti-wrinkle treatments such as Dysport, Botox, and dermal fillers, the treatment of sun damage and other skin concerns through laser facials and Foto Facials, laser hair removal services, skin tightening treatments, chemical peels, stretch mark reduction, and, more recently, laser tattoo removal and laser nail fungus treatments. View a complete list of our aesthetic and medical services here

We opened our business almost seven years ago and have continuously grown over the years – adding more clinicians, nurses, and recently a Physician’s Assistant, all of whom have been extensively trained by Dr. Perkins. We have also added more innovative and effective treatments for a more robust menu. In so doing, we have outgrown our current location and are excited to be moving to a much larger building. We will be closed for the move from Wednesday, October 24th, to Tuesday, October 30th. Our new location will be open for business on Wednesday, October 31st, at 350 Chapala Street, Suite 103 (on the corner of Gutierrez and Chapala), in downtown Santa Barbara.

Thank you for your years of loyalty and support and we invite you to come see us at our new location soon!

Tightening and Lightening in Santa Barbara: Evolutions Event Recap

Santa Barbara cosmetic surgeon Dr. Terry Perkins (and also founder and Medical Director of Evolutions) gave a very informative presentation this evening at our Educational Event.  A recap of the presentation follows:

“Tightening and Lightening” Plus Sublative Rejuvenation


What is skin laxity and how can we treat it?
The skin becomes lax, and has more of a “hanging” appearance, due to damage to and loss of collagen and elastin. Skin laxity can be attributed to the natural part of aging but it is also relate to sun damage.

How can we treat skin laxity?
There are surgical options such as traditional surgery (facelift) and deep peels that help restore collagen and tighten the appearance of the skin. There are different ways to treat skin laxity non-surgically and that includes light based, radio frequency, and focused ultrasound treatments.

Treating skin laxity non-surgically involves sustained heating of the dermis. The immediate effect is collagen contraction and the long term effect results in the stimulation of new collagen to be produced. When we heat the dermis in these tightening treatments, the epidermis (outermost layers of the skin) are protected.

Who are the best clients for a skin tightening treatment at Evolutions?
Age is not a barrier. Clients can range in age from 30 to 80+ years. Best results are usually seen with clients that have a minimum amount of excess fat in the area of concern and when their skin is neither very thin or very thick. Non-surgical tightening is great for someone who wants to address their skin laxity but is not ready for surgery. It is important to have realistic expectations. Skin tightening treatments at Evolutions can turn back the clock a few years, but not decades.

Titan Skin Tightening Treatment

Titan Skin Tightening Treatment

Titan Skin Tightening Treatment

 Titan uses an infrared light to heat the dermis, well beneath the surface of the skin. The heating contracts existing collagen and stimulates new collagen to be produced.

On the right is a before and after photo (courtesy of John Hunts, M.D.) of a Titan treatment on the eyelids. The “after” photo was taken two weeks after the 5th treatment.

Titan treatments can be done on many areas of the body including the jawline, under the chin, and the abdomen to tighten the skin and reverse the signs of aging. Results are cumulative and most clients have two to four treatments over a few months although a single treatment may produce good results for some.


ReFirme Treatment

ReFirme Treatment

ReFirme™ Skin Tightening Treatment

ReFirme™ features the revolutionary elōs technology which simultaneously combines the power of bi-polar radio frequency (RF) and light energies to precisely heat the dermal tissue in the targeted treatment area.

ReFirme™ treatments can help be done safely and effectively on the face, neck, abdomen, upper arms, and knees. In addition to improving skin laxity, it also addresses wrinkles and textural irregularities.

Total Tightening Treatment at Evolutions

This treatment combines ReFirme™ and Titan into one treatment to maximize the benefits of both treatments. Total Tightening synergistically works to heat the entire upper half of the dermis. With each treatment, the existing collagen is tightened as well as stimulating new collagen production that results in tighter, “fresher” skin.

The results are cumulative and therefore we recommend a package that includes 4 treatments done four to six weeks apart. Total Tightening is truly “the best of both worlds” in non-surgical skin tightening technology and is exclusive to Evolutions Medical Spa.


What is pigmentation?
Pigmentation refers to the coloring of person’s skin, often it is the word pigmentation is used when it is distinctive or in excess (as in spots on the skin). Pigmentation is created by melanin in the skin. Different skin types have different levels of melanocytes and that is how different skin colors occur.

Why does the body produce melanin?
Melanin is produced at a normal level based on skin type. However, when the skin is exposed to trauma, inflammation, or exposure to the sun (a suntan is equal to a skin injury), the amount of melanin rises in response to these events. Melanin can also be accentuated by hormones, birth control pills, and pregnancy.

When Pigmentation Problems Arise
Over-stimulated melanocytes create appearance problems such as sun damage, age spots, “liver” spots, freckles, post-inflammatory hyperpigmentation, and melasma (dermal and epidermal pigmentation).

Treatment for Pigmentation 
There are quite a few options for excess pigmentation:

Sunscreen: prevention is your best defense against pigmentation. Use it daily, year round!

Home Care: bleaching agents can help to lighten the skin while exfoliating agents can help to brighten the skin. Recommended bleaching agents are Obagi Clear, C-RX Night (with hydroquinone), Revale Illuminesse Brightening Complex, Nia24 products, and retinoids.  Exfoliating agents increase cell turnover to freshen the skin. Examples of effective exfoliating agents are alpha-hydroxy acids, amino fruit acids (AFA Exfoliating Gel), and retinoids.

Chemical Peels: exfoliate and increase cell turnover in a short amount of time with chemical peels. Recommended chemical peels offered at Evolutions include the Clay Mask Peel, Alpha Beta Peel, Jessner’s Peel, and Obagi Blue Peel. Read in depth about what chemical peels do, how they feel, and descriptions of all the chemical peels offered at Evolutions in this blog post.

Vibradermabrasion: treat superficial pigmentation problems with no downtime through Vibraderm, a physical exfoliation. Adding on a Vibraderm treatment to facials and peels as a pre-treatment will improve the penetration of the products and/or the peel. Vibraderm does not have a suction component to the treatment so there is no risk of broken capillaries as there is with a microdermabrasion treatment.

Light-based Treatments: use intense pulsed light (IPL) and radio frequency technology to reduce excess pigmentation. They are safe and non-invasive.

  • FotoFacial RF™: this is the “gold standard” for the treatment of pigmentation and works deeper than most chemical peels. It is available in a series or in combination with other treatments such as a FotoPeel, FotoPeel Plus, and FotoFacial Genesis packages.
  • Q-Plus C (Q-Switched Laser): this laser can treat spots individually or can treat an entire area with our new Q-Peel package. The Q-Switched Laser works in pulses of billionths of a second to “explode” pigment. It can treat pigmentation issues (spots) as well as tattoos of all colors.

Sublative Rejuvenation Plus DNA Repair (New!): a fractional resurfacing device that uses radiofreqency energy instead of light to treat wrinkles, pigment, acne scarring, skin laxity, tone and texture. A Sublative Rejuvenation treatment has less downtime and discomfort than older fractional laser devices (i.e., the Fraxel). A DNA stem cell ampoule is now included with the treatment. The stem cell ampoule introduces genetically flawless live stem cells which influences the older cells to replicate stronger, healthier, more youthful-looking skin cells. This is an FDA-approved treatment that is clinically proven to renew compromised skin. Sublative Rejuvenation can be combined with other light-based treatments such as the FotoFacial RF or Total Tightening.

Chemabrasion: this surgical procedure combines a deep peel with dermabrasion. It treats wrinkles, sun damage, and pigmentation issues. The change can be dramatic. Downtime is approximately one week. This is done by Dr. Perkins at Cosmetic Surgery Center located near Cottage Hospital. Please call his office at 805-563-0000 for a consultation.

In conclusion, Dr. Perkins stressed the importance of daily use of sunscreen. The best way to treat sun damage is to prevent it! When pigment issues do arise, Evolutions offers a number of medical spa treatment options, for all areas of the body, with “at home” options also available.

Evolutions always offers a complimentary consultation for your skin concerns. Please call us at 805-687-0212 to make an appointment or fill out our online consultation form

Chemical Peels in Santa Barbara: Evolutions Event Recap

Yesterday evening Evolutions Medical Spa hosted an educational event about chemical peels and how beneficial they are for all skin conditions and skin types. Santa Barbara cosmetic surgeon, Dr. Terry Perkins, the founder and Medical Director of Evolutions, explained and demystified chemical peels. Following is a recap of his presentation:

How Skin Turnover Works

An understanding of skin will lead to a better understanding of how chemical peels work to freshen the skin. Skin cells are created in the basal layer and move upwards. Cells die as they get closer to skin surface and naturally slough off.  Most people in their youth have skin turnover every 28 days or so. That is why young children and young adults usually have glowing, voluminous skin. As we age cell turnover can slow to 40-45 days coupled with the fact that collagen and elastin naturally decrease and we are left with skin that is “relaxed” and saggy.  Chemical peels help expedite the skin turnover process so that new cells can move to the surface for a result of more normal-looking skin.

What Do Chemical Peels Do?

A chemical peel creates a controlled depth injury to outer layers of skin. The injured tissue then exfoliates or peels and new cells replace the exfoliated cells at a faster rate. Collagen and elastin production is increased. There are several different types of peels, from light to deep:

  • Lighter peels affect the epidermis: typically this is the type of peel you will get at a day spa or this is the layer that is affected by micodermabrasion
  • Medium peels affect the papillary dermis: these more aggressive peels are usually done in a doctor’s office or at a medical spa; you may see improvement in lines, wrinkles, and pigmentation
  • Deep peels affect midway in the dermis: chemabrasion is an example of a deep peel and is done at Cosmetic Surgery Center in the operating room.

Deeper peels have more downtime, but more downtime yields better results.

Benefits of a Chemical Peel

  • Peels can lighten, tighten, brighten (more luminosity to the skin)
  • They smooth skin and improve texture and color uniformity
  • Peels can bring out healthier skin; often any precancerous/abnormal skin may peel off
  • Consistent peels can keep your skin younger-looking skin throughout your lifetime
Commonly Asked Questions about Chemical Peels

Do peels hurt?
The stronger and deeper it is, the more likely you will have some discomfort. Deeper peels feel hot because of the acid on the skin. At Evolutions, we have a hand-held cooling device so the patient can direct cool air where it feels hot.

 Will skin peel off?
This depends on what you are doing. Some of the enzyme peels and the Flash Peel will increase cell turnover with no peeling. In general, most peels do cause sloughing, some degree of peeling skin. We don’t recommend you do a peel right before a big event. Plan to do a peel three to four weeks prior to any special occasion.

Where can peels be done?
Virtually any part of the body: face, neck, chest, hands are all treatable.  You don’t need to do the same peel everywhere, for example, a less aggressive peel can be done below the jawline because skin turnover is less fast, while a more aggressive peel can be done on the face.

Are peels mainly done for aging skin?
Peels can be done for aging skin and there are also peels that can be done to help control acne and slough off the dark pigmentation that some people get after the acne lesion is gone.

Are peels as effective as laser treatments?
Yes, in general. Lasers use light energy to penetrate the skin while chemical peels use acid to reach deeply into the dermis.

Peels Available at Evolutions 

Pumpkin Antioxidant Facial: this pumpkin peel is an enzyme type peel. Pumpkin contains high concentrations of vitamin A, vitamin C, and beta-carotene found in any fruit or vegetable. This facial and peel combination exfoliates and draws out impurities while introducing vitamins, enzymes, and nutrients. There is no downtime, no pain, and no peeling. A very relaxing experience.

* NEW! Flash Peel: this peel is a combination of glycolic, lactic, and salicylic acid that can be customized depending on the client’s skin. It can be a little tingly because of the alpha hydroxy acid. A mask is applied and massaged into the skin which gives the skin added hydration and nourishment. The service is a quick 30 minutes (easily done on your lunch hour). There is little to no peeling and yet the result is clear, rejuvenated skin.

* NEW! Jessner’s Peel: this peel has stood the test of time. Dr. Max Jessner, a dermatologist, came up with this in the early 1900s. He used resorcinol (a cousin to phenol) and mixed it with lactic and salicylic acid to create a peel that is not all that aggressive.  It can be done in multiple layers and as you do more layers, you get a white tinge to the skin, known as “frosting” or “blanching” which means proteins in the skin are starting to denature. It won’t get as deep as the Obagi blue peel because it’s not a strong acid which is why we classify it as a light peel to medium peel. Jessner’s Peel is especially helpful for acneic and/or oily skin. It contains lycopene and red wine (antioxidants for the skin) and is anti-inflammatory and anti-microbial. Good for all for people of all skin types who want to freshen the skin.

Clay Mask Peel (Advanced Acne Facial): this peel is excellent for people with oily or acne-prone skin. The AFA (amino fruit acids) clay mask works to draw out oils and impurities and offers optimal exfoliation.

Alpha Beta Peel: our most popular peel at evolutions! This peel combines alpha hydroxy and beta hydroxy acids into one powerful peel. We can vary the strength by applying it in 2-4 layers. A great choice for clients who want to see results quickly. Typically skin will begin to peel two to four days after the peel is applied and the skin will peel for approximately two to four days after that.

Obagi Blue Peel: the Obagi peel is our most aggressive peel available. The peel comes from a kit made by the medical grade skincare company Obagi.  The peel is available in concentrations of 15% or 20% TCA. We tend to do 20% so the client gets the best result. It is excellent for pigmentation issues. The Obagi Blue Peel is only available through a physicians office.  Downtime is about seven to ten days total.  Usually the peeling process occurs four to five days post application of the peel.

More Aggressive Options

These peels are only available at Dr. Perkins’ office – Cosmetic Surgery Center in Santa Barbara, just two blocks from Cottage Hospital.  For questions or to schedule a consultation about one of these options, call his office directly 805-563-0000.

Comfort Peel: the Comfort Peel is the strongest peel with 23% TCA. It is similar to blue peel but  has a topical anesthetic in it so the first layer stings a bit but the second layer stings less because of the numbing agent in it.

Phenol Peel: this peel can dramatically take care of sun damage and wrinkles. Dr. Perkins estimates that it can get rid of 95% of wrinkles in one treatment.  The downside is that phenol is toxic to melanocytes so the patient may have permanent lightening of the skin. The Phenol Peel is not commonly done anymore because of the lightening side effect.

Chemabrasion: this procedure combines a medium depth TCA peel (35% augmented TCA that has penetrating agents mixed in) with a light dermabrasion. It is done under anesthetic in the operating room. The downtime is about seven to ten days. Chemabrasion can get rid of 75-80% of wrinkles with one treatment.  Post-op care is like caring for a wound –  wash in the morning and evening; keep covered with ointment. This is also a great treatment for acne scarring.

 Improving Peel Results

You can improve the result of your peel by:

  • Doing a home care pre-treatment (recommended for more aggressive peels); the staff at Evolutions can suggest what product(s) to use in the weeks prior to treatment
  • Vibraderm prep: a physical exfoliation that will allow the peel to penetrate evenly and more deeply
  • Stem cell add-on:  from the skincare company DNA, the addition of stem cells helps augment the wound heeling
  • Multiwave LED – light therapy: multiple wavelengths of light speed the wound heeling and may shorten the time that you do not look good
  • Peel series: doing a series of light peels will give you a better result than just doing one; strong peels don’t need to be done in a series but, in some cases, a second follow up peel can be done if the client wants to see even greater results
  • Laser / Light-based treatment combined: we offer the FotoPeel which alternates between Fotofacials and chemical peels.  A great option for sun damage. This series makes people look really good really fast!
  • Ongoing home care / maintenance:  we always encourage our clients to use effective products for ongoing home care; Dr. Perkins has hand picked products from some of the top medical-grade skin care lines to upkeep your skin in between treatments.  We also recommend periodic peels for good maintenance.


Chemical peels are an important component (along with home care and possibly light-based treatments) in improving and maintaining the quality of your skin throughout your life. There are many types of peels for many different purposes. Remember that you don’t need to peel after a peel and all areas of the body can be treated.

To schedule a peel or a complimentary consultation, call us at 805-687-0212. 


Colorescience Mineral Makeup: Santa Barbara Medical Spa Event Recap

Our “Summer Skincare” event provided us with so much information that we have decided to split the recap into three posts – each dedicated to the three topics of the evening – all of which are equally important.  The first topic was about the Clarisonic Skin Care System and can be read here. The second topic was about Obagi Medical Products and can be read here. Our final topic is about Colorescience mineral makeup. 

What is Colorescience Mineral Makeup?

Colorescience is a sunscreen company with an emphasis on beauty.  The company operates under the motto “We will not compromise health for beauty or beauty for health”.  True to those words, Colorescience makeup is made up of pure minerals – there are no dyes, talcs, alcohols, mineral oils or fragrance in their products.  Colorescience uses titanium and zinc –  natural sunscreens – in their products so they protect against sun damage while also correcting your complexion.

Tip: Many makeup companies these days have introduced a “mineral” line of makeup but most of these only contain a trace amount of minerals.  To test the purity of mineral makeup, pour the powder into a glass of water. Mineral makeup should float on top, without falling through (see image on right).

Four Must-Haves from Colorescience

There are four daily steps that will lead to your most perfect canvas:

1 ) Prep and Prime: The first step to a perfect complexion is to minimize the look of pores and fill in fine lines and wrinkles.  Colorescience PRO offers four SPF 20 face primers to set the stage for seamless makeup application:

  • Skin Brightening Primer: illuminates and improves the look of your skin.  A yellow tint refines redness to deliver a vibrant glow.
  • Wild to Mild Primer: one of the most popular primers – Wild to Mild gives a sheer, sun-kissed look while protecting and soothing to even skin tones.
  • Chocolate Mousse Mattifying Primer: this cocoa-based primer is an excellent choice for oily or shiny complexions and darker skin tones.  It works to hydrate and balance and provides a matte finish.
  • About Face Calming Primer: for sensitive skin, this primer diminishes redness and irritation for a calmer complexion.

2) Colore and Correct: Hide imperfections and achieve an overall even skin tone when you colore and correct with Colorescience PRO foundations and correctors. Blend and layer to achieve maximum correction.

  • Sheer Creme Foundation: this silky foundation is designed for seamless coverage.  Use with a powder for a flawless finish.
  • Loose Mineral Foundation SPF 20: this lightweight, very water resistant powder feels as smooth as a cream, but doesn’t dry the skin.
  • Pressed Mineral Foundation: pressed minerals can provide light to full coverage without the thick look of traditional pressed powder.

3) Set and Refresh: Colorescience PRO setting mists turns minerals into a velvety finish.  They keep minerals in place while adding hydration to your skin.  Use throughout the day to revitalize your look. Three types of mist available: Sunforgettable to be used before, during and after sun exposure, Be Still for all skin types, and Problem Skin setting mist.

4) Protect and Shield: Sunforgettable SPF 30 and 50 are lightweight minerals that block 97% and 98.2% (respectively) of the UV rays. The minerals are translucent and feel barely-there so they can be used on men and children without looking like they have makeup on.  Dr. Terry Perkins, of Santa Barbara Cosmetic Surgery Center, recommends using sunscreen year round to keep your skin healthy and youthful. Colorescience Sunforgettable self-dispensing brushes make it easy for men, women, and children to apply, and re-apply, SPF throughout the day.

Tip: Clean the brush two to three times per week.  Spray the brush cleaner on a washcloth and hold brush upright (so the minerals won’t dispense) and swipe back and forth on the washcloth.

Find Colorescience in Santa Barbara at Evolutions Medical Spa.  Next time you’re in, ask one of our clinicians to show you how Colorescience can enhance your look!

Evolutions Event Recap: Dermal Fillers in Santa Barbara

Yesterday’s event at Evolutions Medical Spa in Santa Barbara was a treat for everyone. Our rep from Medicis (the company who makes Restylane, Perlane, and Dysport) delivered a thorough overview on dermal fillers and answered many questions from the audience.  After the presentation, guests were invited to watch Dr. Perkins perform a dermal filler treatment so that they could witness the immediate effects that fillers have!

Here is a recap of the evening’s presentation:

What is Restylane?
Restylane is a dermal filler that is made from hyaluronic acid. Hyaluronic acid is a naturally-occurring substance in your skin that provides fullness and elasticity.  As we age, hyaluronic acid diminishes and the skin loses volume.  Hyaluronic acid recruits water to the skin to encourage fullness. Restylane, and Perlane (another dermal filler), are made from cross-linked hyaluronic acid so that it is not metabolized as fast as the hyaluronic acid that naturally occurs in the body and this gives clients a result that can last six months or more.

What can dermal fillers – Restylane and Perlane – do for me?
Restylane and Perlane can be used to to add volume and fullness to the skin to correct moderate to severe facial wrinkles and folds.  Restylane can also be used for lip enhancement (for patients 21+ years). Restylane is a thinner product that is typically used for wrinkles, fine lines, and delicate areas. Perlane provides more structure and lift.  It is possible to use both products together. Which product you use is best determined by your clinician.  

Where can dermal fillers be used?
The areas treated by Restylane or Perlane are:

  • laugh lines
  • marionette lines
  • lipstick lines
  • corners of mouth
  • lips (Restylane only)
Restylane Filler Santa Barbara


How long do dermal fillers last for?
When you get a filler treatment, there is little to no downtime, and you will see results immediately.  Effects of the filler will last at least  six months. In a clinical study, 95% of patients who returned for a second treatment 4.5 to 9 months after initial treatment continued to see results for up to 18 months. For some patients, receiving a second treatment before the first treatment completely wears off is a better value because they may achieve the same results with less product. For instance, a patient who had 2 syringes done in the first treatment, may only need 1 syringe in the follow up. Of course this may vary by individual.

How safe are dermal fillers?
Restylane was approved by the FDA for cosmetic use in 2005. It is composed of non-animal stabilized hyaluronic acid which means there is limited risk of animal-based disease transmission or development of allergic reactions to the proteins.  No allergy testing is required before use.  It is fully biocompatible.  Restylane is used in over 70 countries worldwide.

Are there side effects to Restylane or Perlane?
Some people may experience swelling at the injection site, redness, pain, tenderness or bruising up to about seven days after treatment.  Side effects vary depending on the individual. Some people will have no side effects. Any bruising is usually easily able to be covered by make-up.

How do I prepare for my filler treatment?
It is suggested that you stop the following medications and supplements one week prior to treatment: St. John’s Wart, high doses of Vitamin E, aspirin, or non-steroidal anti-inflammatory medicines (ibuprofen) as these may increase bruising or bleeding at the injection site.

Are there people that should not have a dermal filler treatment?
Treatment is not recommended for people who are pregnant, breastfeeding, under 18 years of age, or have a bleeding disorder. If you suffer from cold sores, discuss this with the clinician before treatment.

I’d like to discuss this further before scheduling a treatment …
At Evolutions we always offer a complimentary consultation so that you may have your questions answered and feel confident in your decision.  Schedule a consultation by calling 805.687.0212 or completing our online consultation form.

Evolutions Medical Spa Event Recap: “Brighten Up” with FotoFacials, Laser Facials, Peels and More

Santa Barbara cosmetic surgeon Dr. Terry Perkins – and founder of Evolutions Medical Spa – never ceases to amaze us with the knowledge he holds about the skin and skin care. Last night he shared with a captive audience how to get on the path to clear, bright skin. Here is the recap from the “Brighten Up” educational event at Evolutions.

What stands in the way of luminous skin? For many of us, it is an issue of pigmentation. Pigmentation, also referred to as age spots, “liver” spots, freckles, is caused by melanin.  Melanin is produced as a protection to the skin in response to sun exposure (a sun “tan” is actually a skin injury), trauma, or inflammation. Melanin can also be influenced by hormones, birth control pills, and pregnancy. Appearance problems occur when melanocytes are over stimulated such as post-inflammatory hyperpigmentation (from pimples) or melasma, which is a broad patch of pigmentation that can occur in the epidermal or dermal layers of the skin.

How do we get rid of pigmentation? Below are the options that Dr. Perkins outlined for us:


While Evolutions offers a variety of services that are effective in the treatment of pigmentation problems, Dr. Perkins stressed that it is also important to practice diligent home care to prevent or lighten pigmentation. The #1 recommendation from Dr. Perkins is to wear your sunscreen daily! The fact is that more than half of UV exposure is “incidental” exposure such as sitting near a window, driving in your car, walking outside to chat with your neighbor, you get the picture! UVA actually goes through glass, so you aren’t protected in your car or at your window office.

Evolutions offers a variety of bleaching agents and hydroquinone (which stops the formation of pigment from being formed). Some product recommendations:

  • Obagi Clear and C-Rx Night: a product with hydroquinone as an active ingredient that helps to fade unwanted pigment
  • Revale Illuminating Serum: has the highest potency of antioxidants – good anti-oxidation helps skin repair
  • Nia24: helps skin repair at the DNA level which normalizes pigmentation
  • Retinoids (“Retin A”, “Tretinoin”): help normalize cell differentiation
  • Combination Prescription Products (“Firm and Fade”): offered exclusively at Evolutions that combines Retin-A, hydroquinone, and a low potency steroid (used to calm down inflammation)

In addition to using a brightening/lightening product, you may want to add in a product that encourages cell turnover. Products that contain alpha-hydroxy acids, amino fruit acids, and retinoids are all good choices.


Vibraderm is done using abrasive aluminum paddles that provide a gentle abrasion. It is faster than microdermabrasion and does not have a vacuum component (which can cause broken capillaries).  This physical exfoliation is used to treat superficial pigment problems with no downtime. It will improve the penetration of products / peels and is great as a stand alone service or in conjunction with a peel or facial.


This “Gold Standard” treatment of pigmentation uses Intense Pulsed Light / Radiofrequency to target pigment and “red” areas. A FotoFacial works deeper than most chemical peels and can significantly improve your skin texture by reducing redness, age spots, sun damage, spider veins, fine lines (although not a treatment for wrinkles) and large pores. We offer the FotoFacial in a series or in combination with other treatments (FotoPeel, FotoPeel Plus, and FotoFacial Genesis Packages), depending on an individual’s needs.


Chemical peels are a “controlled” injury to the skin that causes a deep, even exfoliation. At Evolutions we offer different depths of peels (from light to medium to deep).

  • AFA Peels: the alpha-hydroxy peel is a “light” peel for those who want the benefits of a peels without a large amount of actual peeling. This peel can be done alone or in a series of five (recommended).
  • Alpha Beta Peel: this is the most popular peel at Evolutions. It is a medium-depth physical exfoliation and works well to get rid of superficial sun damage and is a great choice for clients who want to see results in 4-5 days.
  • Obagi Blue Peel: this is the deepest peel offered. It will significantly improve your complexion. You will have firmer, clearer, smoother, healthier skin.


This newest laser is used for our newest service – tattoo removal. It delivers laser energy so rapidly that it breaks up pigment without excessive heating of the surrounding tissue.  Currently we are testing how effectively it can treat stubborn brown pigmentation. Stay tuned at a later date for more information on the Q-Switched Laser!


This unique fractional resurfacing device uses radiofrequency energy instead of light to safely treat all skin types. Sublative Rejuvenation is used to treat wrinkles, pigment, acne scarring, skin laxity, tone and texture. There is less downtime and discomfort than older fractional laser devises (i.e. the Fraxel) and it can be combined with other light-based treatments (such as the FotoFacial RF or Total Tightening) for customizable treatment options.


This surgical procedure done by Dr. Perkins at Cosmetic Surgery Center in Santa Barbara (near Cottage Hospital) combines a deep peel with dermabrasion (not microdermabrasion). It treats wrinkles, sun damage, and pigment. You will be very impressed with the results. For more information, contact Cosmetic Surgery Center at 805.563.0000.


The best way to treat sun damage is to prevent it by using your sunscreen daily (on your face, neck, and decolletage). When pigment issues arise, there are a number of treatment options available at Evolutions and “at home”. Pigmentation can be treated on all areas of the body.

At Evolutions we always offer a complimentary consultation. If you are interested in one of our medical spa services, or simply looking for a new home care routine, call us at 805.687.0212 to make an appointment (or book online).

Evolutions February Event: Tattoo Removal and Laser Hair Removal

Evolutions Medical Spa and Santa Barbara cosmetic surgeon Dr. Terry Perkins invite you to join us for an informative evening event about our newest service – Tattoo Removal – and one of our most popular services – Laser Hair Removal next week on Wednesday, February 29th, 2012, 6:30 to 8:30 pm, at Evolutions Medical Spa in Santa Barbara.

Tattoo Removal 101

Find out how this new, state-of-the-art laser technology can remove tattoos of almost any color with less discomfort than older lasers.

Laser Hair Removal Basics

Are you interested in Laser Hair Removal but have questions? Don’t miss this opportunity to find out how laser hair removal works. What types of laser and light-based machines are used for laser hair removal. Why the technology used greatly affects results (hint: one size does not fit all!) and how skin color and hair type can affect your treatment. Learn how long treatments take and if they hurt.

This event will include refreshments, raffles, and exclusive specials for attendees.  Please RSVP to Evolutions at 805.687.0212 to reserve your spot today! 

Evolutions Medical Spa’s 6th Anniversary Event Recap

Thank you to all who attended our event last week to help us celebrate our 6th anniversary! The party was scheduled to begin at 4PM but we had guests lining up well before that so they could be one of the first 50 people to receive a gift bag which was filled with goodies from Revitalash and NuCelle skin care products in addition to loads of product samples from our preferred skin care companies!

Dr. Perkins and the staff at Evolutions mingled with guests throughout the evening and were delighted to watch guests win prizes on the prize wheel, receive complimentary mini-facial treatments and complimentary Colorescience make-up applications, and enjoy appetizers, cupcakes, and drinks. Many representatives from skin care lines were on-hand for interactive skin care education and took pleasure in seeing how their products or treatments have beautified our clientele!

The party continued the rest of the week as the Evolutions’ staff pulled names of winners for the many different gift baskets and called guests to notify them of their winnings on Friday and Saturday.

This year we had over $6,400 worth of items donated from our representatives, from gift sets to syringes of dermal fillers. We’d like to extend a heartfelt THANK YOU to the following companies for their support of the event and the support they give us all year long:

  • AFA Amino Acid Skin Care: comprehensive rejuvenation through powerful exfoliation and moisture retention.
  • Allergan: the maker of BOTOX Cosmetic, the wrinkle-relaxer that  makes a noticeable difference.
  • Clarisonic: Dr. Perkins #1 recommendation for your at-home skin care routine – the Clarisonic Facial Brush.
  • Colorescience: high performance mineral makeup that camouflages skin concerns and protects skin from sun and environmental damage.
  • DNA Health Institute: skin care products that are rich in plant nutrients, essential oils and are environmentally friendly.
  • elure: advanced lightening technology that reduces dark-colored pigment in just 28 days (for most people).
  • Medicis: the company that brings us the dermal fillers – Restylane and Perlane – and Dysport – the anti-wrinkle treatment.
  • Nectifirm: scientifically advanced technology to firm and tighten the neck along with reducing the appearance of fatty tissue and lessening fine lines and wrinkles.
  • Neova: breakthrough skin care that targets photodamaged skin to visibly repair it.
  • Nia24: Niacin-powered skin care therapy to reverse signs of sun damage, improve texture, tone and resilience against future damage.
  • NuCelle: almond-based Mandelic Acid skin care line gently peels away the effects of weather, time and the environment to reveal smooth, clean, radiant skin.
  • Obagi: medical-grade skin care products for all ages and every type of skin.
  • Radiesse: volumizing wrinkle filler that replenishes lost volume and stimulates your own collagen to grow.
  • Revale: skin care products made from CoffeeBerry extract – one of nature’s most potent antioxidants – to protect and nourish as well as restore and revitalize the skin.
  • Revitalash: revolutionary products utilizing the power of peptides and botanicals to help grow eyelashes and eyebrows.
  • VitaMedica: physician formulated nutraceuticals (vitamins and supplements) to support recovery and wellness.
  • White Science: the leading manufacturer of teeth whitening products and patented whitening delivery systems in the U.S.
We’d also like to extend a super, heartfelt THANK YOU to all of our clients and friends that have supported us over the years! We look forward to continuing our relationship with you in our new and bigger location (hope to move in late Spring 2012). 

Check out our event pictures on Facebook and while you are there, “Like” us to stay up to the minute on treatment specials, educational events, skin care tips and more! Connect with us on Twitter too!