Lunch Time Procedures

The term “Lunchtime Procedure” is commonly used today to describe a treatment that can be done quickly and without “downtime”. I think this term can sometimes be over-used by marketing. This is primarily due to the attractive thought of a walk-in, walk-out procedure done on your lunch break that does not require interruption of our busy lifestyle.

Skin Rejuvination


Skin resurfacing is a term we use when discussing a process used to improve the texture of the skin by removing the outer layers of skin. Various technologies have been used for this including microdermabrasion, chemical peels, and laser. For mild texture changes, microdermabrasion may be sufficient, but for serious lines, especially around the mouth,

Hand Rejuvenation

The appearance of a person’s hands can really betray their age. We sometimes focus so much on taking care of our face and neck that it is easy to forget about the sunspots and aging on our hands. That forgetfulness is unfortunate because there is a lot we can do to make our hands more youthful.

Erbium Laser Peel

Erbium Laser Peel

                The erbium laser is my favorite tool for resurfacing the skin. I recommend it any time the patient’s goal is a smoother skin texture. The erbium’s wavelength is absorbed so well by the water in the skin that there is instantaneous vaporization of old skin without depositing as much heat as other lasers.

Kybella Chin Chat

Research shows many people are troubled by under chin fat. Reducing this fat makes women appear thinner and gives men a stronger more masculine jawline. Kybella was developed for this purpose.

Kybella is a non-surgical treatment for submental (under the chin) fat. Kybella treatment is the results of nine years of study on over three thousand treatments using tiny injections into the unwanted fat.



For patients with severe acne that is not controlled with traditional approaches, I am a big fan of “low dose” or “baby dose” Accutane. The reduced dose protocol has been shown to be effective and much safer than traditional dosing.

Accutane is an oral form of vitamin A. It is taken once daily and improves acne for almost everyone who takes it.

Acne Care II

For many, home skin care does not control problem acne. If this is the case,

Chemical Peels:

Peels are helpful for most types of acne. They exfoliate and stimulate the skin. There is down time of peeling. Mild peels- 1-3 days of dry skin. Aggressive peels- 7-10 days of peeling.

Oral medications:

Antibiotics: I feel antibiotics should be limited to short term therapy;

Acne Care I

Everyone can relate to the horror of waking up the day before an important event and seeing a new pimple. For some, this is a rare occurrence and for others the outbreaks are severe and constant. The emotional liability is tremendous and deserves dedicated treatment. Acne is frequently considered an adolescent problem, but it is important to understand that much of the severe acne occurs in adulthood.

Treatment for Cellulite – AWT

Treatment for Cellulite – AWT

AWT stands for Acoustic Wave Therapy. This science has been used for years to treat a variety of issues including cellulite. Cellulite is an alteration of the skin surface that is poorly understood but is known to be related to multiple factors including vascular changes, estrogen effects, and the alteration of normal fibrous tissue septae that compartmentalize the fat cells.

Dermal Fillers

Dermal Fillers

Dermal Fillers are used for adding or replacing volume to the facial structures. Some of the more well-known fillers are Juvederm, Restalyne, and Radiesse. Over the past 10 years there has been technological advances in fillers leading to more areas we can treat, longer lasting results, and a more natural appearance.

Core 4

Core 4

Every day I get the question, “What can I do to look younger?” We are very fortunate today to have an abundance of choices for improving our skin and fighting the changes of father time. There are so many treatments available that it can be confusing. To help you understand how to approach our goal of looking our best,

Family Rest and Relaxation

Family Rest and Relaxation

Today, I thought I would deviate from med spa talk and do something different. Some of you know my Dad recently passed away. As I reflected on my life with him, I was reminded of how he made family recreation a big part of our life. I think this contributed greatly to our family closeness and love that carries on today with my siblings and their families.



I have chosen ThermiVa for feminine rejuvenation at Pure Radiance for several reasons. First, the radiofrequency waves of Thermi can penetrate much deeper than laser waves. This is important because the effect of these treatments is dependent on how deep the thermal effect can reach. Both ThermiVa and laser can treat the skin of the vagina,

Feminine Rejuvenation; ThermiVA

One of the newest topics in aesthetics is feminine rejuvenation. So what is all the buzz about?

Since history began, women have suffered from the traumatic effects of childbirth. Having a baby can damage the pelvic floor causing urinary incontinence, difficulty urinating, having a bowel movement, and decreased sexual satisfaction.

In the past 20 years,

Botox Results

In the last section on Botox, I discussed how the product is administered.  Now let’s see what happens.  After receiving the treatment, the patient will notice gradual weakening of the treated area.  Over a 10-14 day period the full effect sets in.  The patient sees much less movement and wrinkles soften a bit.  If the upper face is treated,

The Procedure

The Procedure

            In this section of our discussion about Botox, I will explain how we do the actual treatment.

The Botox comes vacuum dried in a small vial and must be reconstituted with saline. Each doctor determines the dilution factor that works best for their technique. The “strength” of the Botox is measured by “activity units”,

Botox Safety

Many of the misconceptions about Botox concern its safety. We have all seen movies that used a Botox mishap for comic relief as well as many unflattering Hollywood facial changes that have been attributed to Botox. For the most part, these allegations are unfounded. Today’s Botox Cosmetic is extremely safe. It has been used on millions of persons for many years and retains an excellent safety record.

How Botox Works

            Early researchers knew that certain wrinkles of the face are produced by repetitive motion of the skin caused by contraction of facial muscles. The contraction of the skin causes destruction of skin structures I call tissue matrix. The repetitive destruction of the tissue matrix eventually causes texture changes, followed by fine lines, and eventually wrinkles that continue to worsen with age.




Botox is one of the most popular aesthetic procedures of all time. As more people become familiar with how safe and effective Botox is for reducing the signs of aging, its popularity is expected to continue to grow.


Despite the popularity of Botox,

Photofacial (BBL)

Broad Band Light, known as BBL, has been used commercially for aesthetic purposes since the 1990s. It was the fabulous results that my friend received from BBL that peaked my interest in what later became the “Med Spa” concept.

Over the past 20 years, BBL has been used for many purposes,

Skin Specific Products

Now that we have covered the basics of skincare in the previous blogs, let’s talk about some products in a class I call skin specific. These are products not everyone needs, but will benefit people with specific concerns. In the next few blogs, I will discuss pigment modulators, toners, scrubs, hydrators and eye cream.


Growth Factors

Growth factors are a class of skincare which are relatively new. These are a result of new technology and are good news for aging, weak skin. As we age, obvious thinning and loss of firmness of the skin occurs from decreasing the tissue matrix in the dermis, just below the epidermis. Growth factors work deep in the skin to promote new collagen and elastin production,

Acid Exfoliation

Exfoliation has forever been known to benefit skin health. In the office, we use chemical peels, microdermabrasion and laser for exfoliation. It is good to incorporate an acid exfoliant into your homecare. These range from mild to strong. The product is typically applied in the morning after your antioxidant (see previous blog). These acids are formulated to gently remove a thin layer of the dead cells on your skin like removing a sheet off a bed.


So far, I have reviewed the importance of sunblock, hydration, and Retin A. Now let’s move on to antioxidants. I think antioxidants are the most underrated and neglected steps of skin care. Antioxidants are important for our general health, but even if our diet is sufficient in antioxidants, our skin will benefit from application of a topical antioxidant.

Cellular Renewal

Cellular Renewal is the term I use for encouraging new healthy skin growth. There are many ways to do this but the single most effective way is Retin A. Retin A is actually Vitamin A for topical use. It has multiple effects at the basal layer of the skin where new skin is born. The result is stronger,


For hygienic purposes and to prepare the skin for the most effective results of excellent products available today, we must cleanse the skin twice daily. Many over the counter cleansers will dry and damage the skin when used this often. Medical Grade Cleansers are safe and formulated for specific skin types (normal skin, sensitive skin,


The skin is the largest organ in your body, but it is the last to receive hydration and nutrients from your circulation. Staying well hydrated ensures your skin will get the water it needs. That means you need to drink water throughout the day. My rule of thumb is: if you go more than two hours without needing to tinkle,

Sun Protection

You have heard this over and over, but are you buying into it? I recall a 90-year-old patient I saw in the emergency room. Her face and neck were as wrinkled and saggy as a Shar-Pei and covered with sunspots. When I listened to her lungs with my stethoscope, I marveled at the smooth tight unspotted skin of her back.

Skincare Overview: The Procedure Between the Procedures

As we enter a new year, I want to review the things we need to do for keeping our skin young and healthy. Home skin care is the Foundation for healthy skin. I consider it the procedure between procedures. We have multiple office procedures for improving the skin, and guess what? When you maximize skin health at home,