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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

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 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.

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

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Obagi Skincare: 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. Our next topic is about Obagi Medical Products.

What is Obagi about?

Obagi has been around for almost 20 years and is the #1 prescription strength skincare line.  Obagi products transform skin cells to achieve beautiful, healthy skin. Obagi is for everyone – they have skin care lines for all types of skin and skin issues. Most Obagi systems are used from 12 to 18 weeks and afterward a maintenance program is designed to keep the skin looking great.  This post will cover the various Obagi skin care systems.

Obagi Nu-Derm System

An anti-aging therapy that penetrates below the skin’s surface to transform skin cell functions. It is the #1 selling system and is the most aggressive.  Use it for moderate to severe photodamage, heavy melasma, and more severe fine lines and wrinkles.  There are multiple steps involved in the system and it is used morning and evening. The bottles are clearly labelled and a routine is easy to establish.  Tretinoin (Retin-A) has to be added to tObagi-Logohe system separately (available at Evolutions).  The Nu-Derm system will:

  • Reduce hyperpigmentation (discoloration)
  • Transform rough skin
  • Alleviate sallowness
  • Prevent acne flares
  • Improve skin laxity
  • Diminish fine lines and wrinkles

Obagi C-RX System

This system rejuvenates skin with the use of L-ascorbic acid (an antioxidant that protects skin from free radicals) and prescription strength 4% hydroquinone (a lightening agent to gradually fade brown spots).  It is ideal for mild to moderate photodamage, mild wrinkles, freckles, and fine lines. This is another multi-step system that helps to restore and maintain younger looking skin.

Obagi ELASTIderm Eye Products

An eye treatment that actually brings back the lift around your eyes! Most eye creams simply plump the eye area.  This patented eye product helps to restore elasticity and reduce the appearance of fine lines and wrinkles. Use it under the eye and on the upper eye area as well.  It can be used in combination with other Obagi systems or alone.  It is available in a cream, for those who want more moisture, and a gel, which is lighter and less moisturizing. People see results in as little as two weeks.

Obagi Decolletage System

Similar to ELASTIderm eye cream, this system is designed for the neck and chest, thinner skin areas that often get neglected (less moisturized or overlooked in your sun protection regimen). The Decolletage system fixes the elasticity in the neck and chest and also has a lightening component to help erase sun damage. Generally it is well-tolerated for most skin types and easily absorbed.

Obagi Rosaclear System

This system is ideal for those who have rosacea or redness of the skin.  It also helps reduce the redness of blemishes caused by rosacea. The Rosaclear system is gentle, and non-comedogenic.  It consists of a cleanser, topical gel, hydrating corrector, and a skin balancing sun protection SPF 30.

Obagi CLENZIderm System

The CLENZIderm system is ideal for those who suffer from acne.  It contains a solubilized form of 5% benzoyl peroxide and salicyclic acid to deeply penetrate into the follicle to treat acne at the root, where it starts. It is as effective as a topical prescription.  There are two types of cleansers, depending on skin type, a pore therapy product, cream cleanser, and moisturizer.  Add in a sun protection of at least SPF 30.

Obagi Blue Peel

This chemical peel helps to restore tighter, smoother, clearer, healthier skin.  This peel is the deepest, most aggressive peel available at Evolutions Medical Spa and offers a significant result in a short time period. It is a good peel for those with pigmentation issues.

Evolutions Medical Spa is the longest open-selling Obagi account in the Santa Barbara area.  Obagi products are prescription strength and it is recommended that you use them with physician supervision because they are more aggressive than over-the-counter skin care products.  Evolutions invites you to a complimentary consultation to discuss which Obagi product line will best fit your skincare needs.  To make an appointment, call Evolutions at 805-687-0212.


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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:

HOME CARE

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

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

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!

SUBLATIVE REJUVENATION

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.

CHEMABRASION

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.

CONCLUSION

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).

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Evolutions Event Recap: Tightening and Lightening

On Wednesday evening, Evolutions Medical Spa and Santa Barbara cosmetic surgeon Dr. Terry Perkins hosted an interactive and educational event about Tightening and Lightening the skin. Both tightening and lightening can be done at Evolutions through various services, without invasive surgery, and will yield noticeable results!

Part I: SKIN TIGHTENING – Facial Rejuvenation 

What is skin laxity?

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).
  • Non-surgical treatments include light-based (FotoFacial), radiofrequency (Sublative Rejuvenation, ReFirme), and focused ultrasound.

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:
  1. Phase Five Peel / Clay Mask Peel
  2. Alpha Beta Peel
  3. Comfort Peels (Light, Medium, Deep)
  4. Obagi Blue Peel

Read all about the various chemical peels, how they feel, and how effective they can be, in a various blog post.

  • 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 offers a complimentary consultation by filling out our online form or calling 805.687.0212.

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Elure Advanced Skin Lightening at Evolutions Santa Barbara

Bbeauty Bpublic BrelationsHave you heard of elure? This super advanced skin lightening product has created a huge buzz. In fact, elure has been voted Top New Beauty Product of the Year by Allure magazine (coming out this month) and was featured on the Dr. Oz show and the Today Show this week!

What is elure?
elure is a topical cosmetic only available from a physician’s office that reduces dark-colored pigment (hyperpigmentation, sun spots, age spots, “liver” spots) on your skin.

How is elure different than other lightening products?
Past lightening products addressed dark spots by blocking the production of melanin deep within the skin, eventually causing the discoloration to fade. When we say “eventually” that usually means many months or more to see a gradual fading. And if the spot is re-exposed to sun, the melanin can be re-triggered, working against the fading process.

elure is based on a patented natural enzyme, Melanozyme™, that destroys the melanin accumulating on the skin’s surface. Clinical trials revealed a visible improvement within seven days and significant improvement just after one month! As a bonus, for those who are sensitive to hydroquinone, elure is not irritating.

today-show-elure-beauty-product

elure is available in Santa Barbara at Evolutions Medical Spa. Get it now and get rid of your hyperpigmentation fast! For questions about elure, call Evolutions at 805.687.0212 or visit us at 1309 State Street, Santa Barbara.

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