Category Archives: Skin care

Permanent Hair Removal – Your Guide to Laser Hair Removal and Electrolysis

woman getting laser hair removal over the underarm, over a photo of a woman's legs

Is permanent hair removal really possible?

Emphatically yes! There are two types of permanent hair removal we do at my practice: laser hair removal, and electrolysis. I will discuss them both today, including how they work, what areas can be treated, what the treatment feels like, and the cost.

Laser hair removalWoman having underarm treated with laser hair removal

Laser hair removal (LHR) is the most popular type of permanent hair removal. It can be done on most areas of the body, including the legs, arms, underarm, back, upper lip, and cheeks.

  • LHR works by damaging the hair follicle. So the hair isn’t actually gone, but it’s so fine and thin you can’t really see it, like the hairs on your cheek.
  • Hair growth can change with hormones, so you may see increased hair growth with puberty, pregnancy, or menopause. If that occurs, additional treatments may be needed

myths of laser hair removal

What does laser hair removal cost?

Laser hair removal is usually sold in a package of treatments. Hair rotates through a growth cycle, and only the actively growing hairs are affected by the laser. Depending on the body area, 6-12 treatments are needed to get a good result. Expect to pay $1500-2000 for a complete treatment package on the legs, or $750-1000 to treat the underarms.

Does laser hair removal hurt?

Yes, LHR is a little uncomfortable. It feels like a flash of heat or maybe a sting. But we apply numbing cream to sensitive areas, such as the upper lip, to help with discomfort. We also have a fan that blows super-cooled air during the treatment; this helps quite a bit as well.

Does laser hair removal work on any hair type?

  • The laser targets the pigment in the hair follicle, so LHR works best on darker hair. It can be effective on lighter hair, but more treatments may be needed.
  • LHR can be safely done on all skin types as well.

Electrolysis

There are two instances when laser hair removal is not a good option:

  1. Gray hair. Gray hair has no pigment, so there isn’t anything for the laser to target.
  2. Eyebrows. Eyebrows take so many laser treatments, and the area is so small, that electrolysis is a more effective option.

What is electrolysis?

Electrolysis uses an electrical current to destroy the hair follicle. A very tiny needle is inserted into the base of the hair follicle to apply the current, then the hair is removed with tweezers.  Electrolysis only removes one hair at a time, so it’s usually scheduled for specific length of time, such as a 30 minute visit. Treatments are repeated until the entire area has been treated.

 

Would you like to find out more about permanent hair removal? Download my freebie below!

myths of laser hair removal

 

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Botox Gone Wrong – Why Does Bad Botox Happen?

botox gone wrong

When I see new patients who want Botox for the first time, they often bring up examples of Botox gone wrong. So what exactly is Botox gone wrong? And why does bad Botox happen? FYI, I use two types of neurotoxin in my practice – Botox and Xeomin. But for the sake of simplicity I will refer to all neurotoxins as Botox.

botox gone wrongHow does Botox work?

Botox is a neurotoxin produced by the Clostridium botulinum bacteria. The toxin acts at the junction between nerves and muscles, and blocks the nerve from transmitting signals to the muscle.  So injecting small amounts directly into a muscle results in paralysis of that muscle.

Botox only works on dynamic rhytids, meaning those that appear with facial expression. If you have visible wrinkles when you aren’t frowning or raising your eyebrows, you may need fillers or laser resurfacing to get an optimal result.

botox or fillers

Botox is most useful on the upper third of the face. I use it over the forehead, on the frown lines between the eyebrows (affectionately called the “elevens” by Allergen, the company that manufactures Botox), and on the crow’s feet around the eyes.

I will occasionally, and cautiously, inject Botox around the mouth. But because it paralyzes muscles, using too much Botox or putting it in the wrong place can cause difficulty speaking and eating. If you’ve ever seen Christmas with the Kranks, the scene where Tim Allen is drooling after getting botox is a great, although exaggerated, example of what could happen if you were to get Botox injected around the mouth. Granted, it would actually take 5-7 days for the Botox to kick in, but then the movie wouldn’t be as funny.

So why does Botox make people look fake?

There are three common examples I see of Botox gone wrong:

  • If your face is totally frozen. I think we’ve all seen that expressionless person who wouldn’t blink an eye if she had a gun pointed at her face. You know. Because she can’t. I’m a big proponent of a natural result, and I think your face should move at least a little bit after Botox injections. Granted, I have patients who like a more dramatic result. And I’m happy to tailor my treatment to their preferences. But my go-to treatment result is very natural.
  • The Spock eyebrow. When botox is injected only over the central forehead, the lateral brow can arch too much and make you bear an unfortunately resemblance to everyone’s favorite Vulcan. Fortunately this is totally correctable; injecting a little Botox over the lateral forehead will take care of the problem.
  • The eyelid droop. Drooping of the upper eyelid can happen when Botox diffuses into the muscles that raise the upper eyelid. This is thankfully very rare; I’ve actually never seen it happen.  The eyelid droop does go away in a couple of months when the Botox wears off, and eyedrops can improve it in the meantime.

Now that you know what causes Botox gone wrong, how do you avoid it? If you want a good result, go to a good doctor. Plastic Surgeons and Dermatologists have special training in cosmetics and facial anatomy that make them the experts at injecting Botox and facial fillers.

Would you like to learn the differences between Botox and fillers? Click on the link to download my freebie!

botox or fillers

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What are those age spots on my arms and hands?

woman with age spot on the left, which is gone in the photo on the right

Do you ever look at your hands while driving and wonder when all those brown spots suddenly popped up?

Or realize you haven’t worn a v-neck sweater in years, because the age spots on your chest will show?

get rid of age spots

Actual patient of Dr. Greer

 Often called age spots or liver spots, these brown spots can actually be one of several things:

  1. Skin cancer. This is obviously the most serious. So if you have a new spot that suddenly popped up, or one that is painful, itchy, or changing color, it’s worth seeing your doctor to make sure everything is okay.
  2. Seborrheic keratosis. Known in the business as SKs (because really, who wants to say seborrheic several times a day?), these brown spots are usually raised and flaky. They can appear anywhere, but most commonly on the back, arms, and templess.
  3. Solar lentigoes. The name literally means “sun spots,” and these brown spots are caused by sun exposure over the years.
Now that we know what’s causing these annoying brown spots, how do we prevent them? As I mentioned above solar lentigoes are related to sun exposure. Wearing daily sunscreen can help prevent them. Unfortunately most of our sun exposure has happened long before we start to see these brown spots, so sunscreen can only help so much. SKs are not related to sun exposure. Some people just develop them with age, and they do seem to run in families. Unfortunately there is no way to prevent SKs.
The good news is that both SKs and solar lentigoes can be treated. SKs are usually cauterized or lasered off. Solar lentigoes are often treated with a combination of laser treatments to pull the pigment out of the skin and skin lighteners such as hydroquinone to prevent the pigmentation from coming back.
If you would like to get rid of your age spots, you’ll likely need a couple of treatments to remove what you currently have, then a touch up once a year to remove anything new. These treatments are done in the office, and have very little downtime. If you’d like to find out more, please call us for a FREE consultation.

(440) 974-8577

Dr. Greer is a plastic surgeon in Cleveland, Ohio. Her passion is helping moms regain their confidence by getting rid of sagginess, wrinkles, and stubborn fat using surgery, laser, Botox and fillers. Check out her website for more information, or to download a FREE copy of “The Busy Mom’s Guide to Plastic Surgery.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Is there a way to prevent skin cancer?

I think we all understand that skin cancer is caused by sun exposure, and that the best prevention is using sunscreen.  But what if you’ve missed the boat on that option? Every day I see patients in their 40s, 50s and older who have already been subjected to many years of sun damage. Wearing sunscreen moving forward is certainly important, but is there a way to improve some of the damage that’s already been done? Thankfully there is.

Topical retinoids may help reduce chronic sun damage. I’ve covered how to use these products in a previous post, so we’ll skip over that here. Two other options are also effective:

  1. Skin resurfacing. Skin resurfacing includes treatments such as dermabrasion, laser peels and chemical peels. These treatments remove the outer layers of the skin, which is where most of the sun-damaged cells reside.
    Pros:

    1. Skin resurfacing will improve fine lines and pigmentation as well as reduce the risk of skin cancer.
    2. The recovery time is only about a week, and these procedures can be done in the office.
      Cons: Skin resurfacing is usually considered cosmetic, and thus is not covered by insurance.
  2. Topical medication. Efudex (fluorouracil) is actually a chemotherapy drug used to treat cancer, which was formulated into a skin cream. It kills abnormal cells, such as those at risk of turning into skin cancer. The medication is used for a few weeks until most of the abnormal cells have been killed.
    Pros:

    1. Efudex is covered by most insurance plans.
    2. Efudex will remove sun-damaged cells that are not visible to the naked eye.
      Cons: Efudex causes skin irritation, rash, and redness, which may persist for up to two months after you stop the treatment.  No makeup can be worn during the treatment period. The photo below is what a typical patient looks like during treatment.

      Side effects of Efudex. From: http://alaneg1948.blogspot.com/2012_05_01_archive.html

      Side effects of Efudex. From: http://alaneg1948.blogspot.com/2012_05_01_archive.html

 

If you are interested in pursuing Efudex or skin resurfacing, I would recommend seeing a board-certified Plastic Surgeon or Dermatologist in your area who has experience treating skin cancer with both of these treatment options.

 

Questions? Leave them in the comments section and I’ll do my best to get back to you.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Will tattooing cover up a scar?

I’ve written previous blog posts about what makes a scar good or bad, but I never addressed the topic of tattooing. Tattooing done to camouflage a scar is referred to as medical tattooing. This is in contrast to cosmetic tattooing, which is done to apply permanent makeup, and the tattooing of artistic designs for body modification.

Tattooing does have a role in scar camouflage, but it must be done after the scar has completely matured. Scars may be raised up and appear red or purple during the initial healing period. They then begin to settle over a period of 6-12 months, eventually becoming flat. The final scar may be lighter than the surrounding skin (hypo-pigmented) or darker than the surrounding skin (hyper-pigmented).  Hypo-pigmented scars may benefit from tattooing, which essentially adds pigment to match the surrounding skin. This should be done on un-tanned skin, so the scar is pigmented the correct color. Remember, however, that if the surrounding skin is exposed to sun, the resulting tan will make the scar more noticeable.

hyper-pigmented scar

hyper-pigmented scar

hypo-pigmented scar

hypo-pigmented scar

 

 

 

 

 

 

 

 

In contrast to a hypo-pigmented scar, a hyper-pigmented scar is darker than the surrounding skin. In this case the treatment is to remove pigment rather than adding it. This can be done with laser or broad-band light (BBL) treatments. I would recommend waiting at least a year to allow your scar to mature, and then seeing a Board-Certified Plastic Surgeon to evaluate your scar. He or she can recommend the best course of treatment, and refer you to a tattoo artist with experience in scar camouflage if necessary.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

What is the difference between Botox and fillers?

I perform many minimally-invasive procedures to treat wrinkles in my office, and I’ve noticed that there is often a lot of confusion about exactly what the difference is between a neurotoxin such as BOTOX, and a filler such as Juvederm or Restylane. My blog post today is written with the intent of clearing up that confusion.

Confusion is understandable, as the two treatments do share many similarities. Both neurotoxins and fillers are injected in the office. Both treat wrinkles. And both are temporary, meaning the results wear off over time. But the two products actually work quite differently.

As I mentioned before, Botox is a neurotoxin. This means it is actually toxic to nerves, thereby preventing muscles from contracting in the areas where it is injected. Muscle contraction is responsible for what are called “dynamic wrinkles”, i.e. wrinkles resulting from motion. Dynamic wrinkles are commonly seen between the eyebrows, over the forehead, and around the eyes. Preventing the muscles from moving stops the wrinkle from forming. Because neurotoxins cause localized muscle paralysis, I do not like to use them around the mouth as this may result in drooling or difficulty speaking and eating.

Fillers do what their name implies: they fill volume. Volume loss in the soft tissues contributes to an aging appearance. This is partially responsible for the formation of the “smile lines” which run from the nose to the corner of the mouth, and the marionette lines which run from the corner of the mouth to the chin. Ptosis or droopiness of the overlying tissue secondary to gravity is the other main contributing factor, and this can be corrected surgically. But adding volume directly under a wrinkle can significantly soften the appearance. Unlike neurotoxins, which require several days to take effect, the results from fillers are immediate.

If you’d like to learn more, check out my previous posts on Botox and other neurotoxins as well as fillers.

Any questions? Leave a comment and I’ll do my best to get back to you.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

Are medical-grade skin care products really better?

Yes! There is absolutely a difference between the skin care products offered over the counter and skin care products sold by physicians.glowing skin

  • The products sold in doctor’s offices contain higher concentrations of active ingredients, meaning they are generally more effective. Treatments for brown spots are a great example. The skin lightening creams available at your local pharmacy contain 2% hydroquinone, the active ingredient which blocks your cells from making pigment. But skin lightening creams available through your Plastic Surgeon have 4% hydroquinone.
  • When you see a Plastic Surgeon or a Dermatologist for skin care products you get the benefit of a skin care plan tailored to your needs. A skin care product may be incredibly effective, but it won’t help you if you’re using it for the wrong reason. Along those same lines, a physician can diagnose what is really going on with your skin, and treat the underlying cause, not just the symptoms.
  • Sometimes your skin takes time to adjust to new products. A doctor can tell you if what you are experiencing is a normal side effect, or if you should stop the product or try a different product instead. Tretinoin (aka Retin A) cream is a great example of this. Tretinoin is very irritating to the skin, so many people stop using it before they see results. But Tretinoin can give some amazing results in terms of smoothing fine lines and evening out pigmentation, if you are able to get through that adjustment period. A doctor experienced with skin care can help you adjust your use to minimize skin irritation, or even prescribe other products to calm down the initial redness and flaking.
  • Plastic Surgeons can also recommend where best to spend your money if you have a limited budget.  Skin care products are a way to help augment the results I achieve from laser procedures, Botox, and fillers. Which means I care about your results, not making a commission. I can tell you which skin care products to purchase at your local pharmacy to save you money, and which ones you really need to buy at my office to see results.

Do you have a question about skin care products? I would love to answer them in the comments section!

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.