“Tightening and Lightening” Plus Sublative Rejuvenation
PART 1: TIGHTENING YOUR SKIN
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 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™ 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.
PART 2: LIGHTENING – IMPROVING EXCESS PIGMENTATION
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.
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.
LIGHT-BASED TREATMENTS : FOTOFACIAL RF
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.
LIGHT-BASED TREATMENTS: Q-SWITCHED LASER
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).
Skin laxity is a result of damage and loss of collagen and elastin – the structural components of the dermis. Collagen provides the rigidity to connective tissues and elastin allows them stretch. As we age collagen loses elasticity and our skin sags. Sun damage also plays a role in aging the skin as well.
How can we treat skin laxity?
There are several options including:
Surgical options such as traditional surgery (face lifts) or deep peels (chemabrasion).
How does treating skin laxity non-surgically work?
It has been found that sustained heating of the dermis works to treat skin laxity. The immediate effect is collagen contraction and long term stimulation of collagen remodeling.
Who is a good candidate for non-surgical skin tightening treatments?
Age is not a barrier – clients can be anywhere from 30 to 80+ years old
Clients who have a minimum amount of excess fat in the area of concern and those with skin that is neither very thin or very thick
Clients who have realistic expectations – the non-surgical procedures can turn back the clock a few years, not decades
A great candidate is someone who is not ready for surgery but still wants to tighten the skin
Skin tightening options available at Evolutions:
Titan: the Titan is a safe infrared light that heats the dermis as well as the skin’s surface. The heating contracts the collagen and stimulates new collagen to be produced.
ReFirme: ReFirme is an FDA cleared non-invasive skin tightening procedure that features elōs technology – a combination of bi-polar radio frequency (RF) and optical energy.
Total Tightening: Dr. Perkins has developed an exclusive protocol combining the technologies or ReFirme and Titan into one treatment called Total Tightening. This treatment synergistically works to heat the entire upper half of the dermis. It is exclusive to Evolutions Medical Spa. A series of 4 treatments is recommended for best results.
Why do you recommend skin tightening treatments in a series?
Laser and light-based treatments are generally done in a series because the energy necessary to cause dramatic change in the skin (which cause injury and then recovery, which is what grows new skin) cannot be accomplished in a single treatment, instead it is the cumulative effects of multiple treatments that yield the best results. If, after a few treatments, a client sees the results they are looking for, they can save the remaining treatments to be used as “maintenance” at a later date.
Part II: SKIN LIGHTENING – Improve Excess Pigmentation
What is pigmentation?
Pigmentation is created by melanin in the skin. Melanin is produced by melanocytes. Different skin types have different levels of melanocyte activity – therefore different skin colors occur within people.
Why does the body produce melanin?
Normal production of melanin is based on skin type. Melanin levels rise in response to sun exposure (such as a sun tan which is equal to a skin injury), trauma, and inflammation. Extra melanin can also be produced due to hormones, birth control pills, and pregnancy.
When do pigmentation problems occur?
If melanocytes are over-stimulate, appearance problems can occur such as:
Sun damage also referred to as age spots, “liver” spots, freckles
Post inflammatory hyperpigmentation can occur with pimples
Melasma – a broad patch of pigmentation – can occur in the dermal or epidermal layers of the skin
Treatment for pigmentation problems The following highlights products and services that are available at Evolutions to treat a number of pigmentation problems.
Sunscreen: your best defense against pigmentation is to prevent it! Year round, daily use of sunscreen is always recommended!
Home Care: there are two categories of home care products that can help lighten and brighten the skin – bleaching agents and exfoliating agents.
Home care bleaching agents: Obagi Clear, C-Rx Night (with hydroquinone), the newest, fastest lightening agent Elure (read more about Elure in a recent blog post), Revale Illumenesse Brightening Complex, Nia24 products, and retinoids (“Retin-A”). At Evolutions we compound our Tretinoin to reduce the price for clients.
Exfoliating agents assist in increasing cell turnover: products with alpha-hydroxy acids, amino fruit acids and retinoids all help to expedite cell turnover (which slows as we age).
Chemical Peels: the fastest way to exfoliate and increase cell turnover is through a chemical peel. Available in multiple strengths, from light to deep, chemical peels can make a dramatic difference in the skin in a matter of days (somewhere between 5 to 10 days, with the skin continuing to improve thereafter). The peels available at Evolutions are:
Vibradermabrasion: this service provides a physical exfoliation that can treat superficial pigment problems (with no downtime). It also is a great add-on service to facials and as a preparation for peels as it will improve the penetration of product or the peel. Vibraderm is superior to the popular microdermabrasion treatment because there is no suction component to it (which can cause broken capillaries).
Light-Based Treatments: these treatments are safe and non-invasive, using intense pulsed light (IPL) and radio frequency technology to diminish imperfections in the skin such as excess pigment as well as “red” areas. The FotoFacial RF is the “gold standard” for treatment of pigmentation and it works deeper than most chemical peels. The FotoFacial is available in a series or in combination with other treatments (FotoPeel, FotoPeel Plus, and FotoFaical Genesis Package).
*NEW* Light-Based Treatment: Evolutions just acquired the brand new Q-Plus C (Q-switched laser) light-based treatment that is able to treat tattoos of all colors and a variety of pigmentation issues.
Sublative Rejuvenation: this fractional surfacing device uses radio frequency energy, instead of light, to treat wrinkles, pigment, acne scarring, skin laxity, tone and texture. There is less downtime and less discomfort that older fractional laser devices (such as the Fraxel) and customizable treatment options are available. Sublative Rejuvenation can be combined with other light-based treatments such as the FotoFacial RF or Total Tightening.
Chemabrasion: this is a surgical procedure that combines a deep peel with dermabrasion. Chemabrasion is a more aggressive option to treat acne scarring and deep wrinkles. The change can be very dramatic. Down time is approximately one week.
Part III: CONCLUSION
The best way to treat sun damage is to prevent it by daily use of sunscreen. When pigment issues arise, there are a number of treatment options available, both at Evolutions and at home. All areas of the body can be treated for pigmentation problems.
Evolutions Medical Spa’s Educational Event last week addressed skin pigmentation and how to “correct” hyperpigmentation concerns. If you have pigmentation concerns, there is no better time than now to address this! Often pigmentation correction may take more than a single treatment so plan ahead, especially if you have a special event in the future that you may want your skin to look glowing and perfect for! Evolutions always extends a complimentary consultation for further questions and information. Fill out our online consultation form or call 805-687-0212 to schedule an appointment.
What is Pigmentation?
Melanin in the skin causes pigmentation – that varies by an individual’s skin color (darker skin has more melanin, lighter skin has less).
Melanin is produced for protection in response to sun exposure (for example, a sun tan is really an “injury” to the skin), trauma, inflammation.
Melanin can be influenced by hormones, birth control pills and pregnancy (the “mask of pregnancy” often appears as melasma, darker spots, on the cheeks).
What if Melanocytes are Over-Stimulated?
Appearance problems of the skin occur when melanocytes are over-stimulated. This hyperpigmentation is commonly referred to as brown spots, age spots, liver spots, and/or sun damage.
Post-inflammatory hyperpigmentation can also occur from pimples.
Melasma – a broad patch of pigmentation – can occur and can be in the epidermal or dermal layers of the skin.
Epidermal pigmentation is more readily treated because of the location – the outer-most layer of the skin. Dermal region pigmentation can be more stubborn to treat. At Evolutions, we use a Wood’s Lamp – a diagnostic dermatology tool – to look at a client’s hyperpigmentation location to find a treatment best suited for them.
Hyperpigmentation Prevention: Use Your Sunblock Daily!
Before we address pigmentation correction treatment options, we want to stress that prevention is key! Santa Barbara cosmetic surgeonDr. Terry Perkins recommends using a sunblock that is at least SPF 30 and is a physical block – one that contains titanium dioxide and/or zinc oxide. Physical sunblocks reflect the sun’s energy whereas chemical sunscreens heat the skin up.
Dr. Perkins and the Evolutions staff recommend to clients a highly effective sunblock called TIZO3 SPF 40. TIZO is free of paraben, oil, PABA and fragrance. It gives the skin superb protection while leaving the skin with a silky, smooth, matte finish. TIZO products are available at Evolutions.
Hyperpigmentation Treatment Options
Home Care: There are many skin lightening agents on the market that are available at your local drugstore or through a physician’s office. Dr. Perkins recommends the Obagi Nu-Derm or Obagi-C Rx programs, PCA Brightening Therapy, NIA 24, and retinoids (also known as “Retin A” or “tretinoin”). Another home care option, maybe in addition to a skin brightening/lightening agent, is to increase cell turnover through products with alpha hydroxy acids (AHA), amino fruit acids, and, again, retinoids.
Chemical Peels: a chemical peel is a “controlled” injury to the skin that creates enough injury to cause an exfoliation. Evolutions offers chemical peels in different strengths, depending on your overall goal and the amount of downtime you may have to dedicate to the process. Read more about chemical peels, what they can do for you, and the types that are offered at Evolutions in a previous blog post dedicated to them.
Vibraderm: a superficial exfoliation using abrasive aluminum paddles that provides a gentle abrasion that is faster than microdermabrasion and does not have a vacuum component (which can cause broken capillaries). Great in a series or with in conjunction with other procedures as it will improve the penetration of treatment products and chemical peels.
FotoFacial RF™: an Intense Pulsed Light (IPL) treatment with a broad spectrum of light that gives the FotoFacial RF™ the ability to treat different parts of the skin as the light is absorbed at different levels. The FotoFacial RF™ significantly improves your skin texture and appearance by reducing redness or rosacea, age spots, sun damage, spider veins, fine lines, uneven pigmentation and large pores. It is not a treatment for wrinkles. Your skin may be pink on the day of treatment but other than that, there is little down time.
Sublative Rejuvenation: the newest fractional resurfacing device on the market that uses radiofrequency and can treat any skin color. It can treat mild to moderate wrinkles, brown spots, and can improve the appearance of acne scars and textural irregularities. There is less discomfort with this newer treatment in comparison to the older Matrix RF treatment and the down time is not as long.
Chemabrasion: this treatment is done at Cosmetic Surgery Center by Dr. Perkins. It combines a mid-dermis peel with dermabrasion. For more information on chemabrasion, set up a consultation with Dr. Perkins at Cosmetic Surgery Center, 805-563-0000.
Every person is unique and so is their skin type and pigmentation issues. If you are interested in receiving a personalized pigmentation correction plan, schedule a complimentary consultation at Evolutions by calling 805-687-0212. We would be happy to customize a treatment plan for you!
Learn about new and innovative medical treatments that can brighten the skin and reduce unwanted pigmentation from Santa Barbara cosmetic surgeonDr. Terry Perkins. Therapeutic home care that can brighten the skin every day will also be discussed.
Attendees will receive exclusive specials on chemical peels, FotoFacials, FotoPeels and FotoGenesis and on skin lightening products including Obagi. The event is complimentary and includes a raffle and refreshments.
At Evolutions Medical Spa, we continue to receive excellent feedback from our clients on our newest procedure, Sublative Rejuvenation. There is little to no pain associated with the treatment and it can be used to effectively treat and improve:
Skin irregularities (i.e., acne scarring)
General tone, texture, and color of skin
Skin laxity (including the face and chest!)
Mild to moderate wrinkles
Sun damage, age spots, and other unwanted pigmentation
Though it’s a great treatment by itself, Santa Barbara cosmetic surgeonDr. Perkins has recently finished protocols for combination treatments with Sublative/Total Tightening (for the best non-invasive tightening procedure available anywhere) and Sublative/FotoFacial (for a “supercharged” skin rejuvenation series). Most of these combo treatments include product credit so you can combine the in office treatments with medical grade home care for maximum benefit!
Finally, there are new “small area” treatment tips available at a reduced price. These are perfect for around the eyes and mouth or for concentrated problem areas (such as acne scarring on the cheeks).
Call Evolutions at 805-687-0212 for more information or to book a complimentary consultation.