Medical Aesthetics

What is laser skin resurfacing

Laser skin resurfacing, also called lasabrasion, laser pelling, or laser vaporization is the process of using lasers to help reduce a wide variety of skin conditions such as wrinkles, scars, blemishes from your skin. 

Types of Lasers

There are two types of lasers used in laser skin resurfacing, that is ablative lasers and non-ablative lasers. Each type of laser has its own advantages, and this guide will help you determine which type of laser is best for you. These two types are ablative and nonablative lasers. 

• Ablative lasers – These lasers work by removing the outer layer of skin known as the epidermis and stimulates the underlying skin, the dermis. These types of treatments are more invasive, making them a better choice for treating mild to moderate wrinkles, facial scarring, and skin discoloration. You will see results after one treatment, but the recovery process will be longer. As the epidermis heals and regrows, the treated area appears smoother and tighter. Types of ablative treatments include the following.
  • Fractional C02
  • Erbium 
  • Combination systems

• Nonablative laser– These lasers improve the appearance of mild wrinkles, minor scars, and discolorations like liver spots by heating the skin without injuring the surface of the skin. These lasers stimulate collagen growth, which over time helps improve skin tone and texture. This approach can be done with various types of lasers as well as intense Broadband light (BBL). Non-Ablative laser resurfacing is less invasive and requires less recovery time than ablative laser resurfacing.
  • ND: Yag
  • Broadband light
  • Moxi

What can laser skin resurfacing treat?

Laser skin resurfacing can be used to treat a number of skin conditions. 

• Wrinkles
• Skin irregularities such as acne scars or blemishes
• Aged or sun damaged skin
• Eczema
• Stretch marks
• Warts
• Liver spots
• Birthmarks
• Enlarged oil glands
• Tattoos 

Who can get laser 

Laser skin resurfacing is a good option if you have been trying over the counter products of one of the above skin conditions without results. You should consult your doctor if you have one of the following disqualifiers. 

• Have taken the acne medication isotretinoin during the previous year
• Have an autoimmune disease or a weak immune system
• Have had radiation therapy on your face
• Are prone to cold sores or have had a recent outbreak of cold sores or herpes virus
• Have a darker skin tone
  • Certain lasers do not work as well with darker skin tones, but your surgeon will know which is best (like Erbium or Moxi)
• Are pregnant or breastfeeding

Who performs the procedure? 

There is a lot of information floating around about what qualifications are adequate.You should have your surgery performed by a plastic surgeon or dermatologist certified by one of three boards. The top tier of qualification would be a surgeon certified by the American Board of Medical Specialties (ABMS). This is the highest standard for specialty medical practice and physicians must meet the highest standard to become Board Certified. To become certified by the ABMS, a surgeon must have at least six years of surgical training, as well as an accredited plastic surgery training program. They must also complete thousands of hours of cosmetic and reconstructive surgery procedures, and pass a rigorous written and oral examination, as well as continued education to maintain their accreditation. The ABMS recognizes two other boards, the American Board of Plastic Surgery, and the American Board of Facial Plastic and Reconstructive Surgery. The ABMS does not certify cosmetic surgeons. Many cosmetic surgeons are certified by the American Board of Cosmetic Surgery (ABCS) however this board is not recognized by the ABMS. The requirements to become certified by the ABCS are much less rigorous, they require experience in 300 procedures along with one oral and written exam, there are no continued education requirements. In 2018 California ruled that ABCS was denied the right to advertise as “Board Certified”. Use this link to find out if your surgeon is an ABMS Certified practitioner.

Things to know before your laser skin resurfacing appointment 

If you get cold sores or fever blisters around your mouth, laser skin resurfacing can trigger breakouts. 10 days before your appointment you should refrain from taking supplements and medications such as ibuprofen, aspirin, and vitamin E. NASID’s (non steroid anti inflammatory drugs) such as aspirin and ibuprofen thin your blood and make it harder for damaged skin to clot. This could lead to excessive bleeding after your procedure so it is best to avoid these starting 10 days before your appointment. 

Depending on your procedure, you will likely receive some form of anesthetic. Some non-invasive forms of anesthetic include topical creams, cryoanesthesia, or a combination of both. Some more invasive forms include nerve blockers, a local anesthetic injection, and finally supervised anesthesia. 

Types of lasers and their specialties 

Fractional C02

Laser to the dermis deeper layer of skin, laser stimulates and rejuvenates cells to produce collagen and produces a more natural appearance,  blending with the surrounding skin, the end result is more elastic skin, improved texture and quality, and more youthful appearance.Results produce lasting a natural results, your skin rejuvenates itself

Recovery happens in two phases

1. 7-10 days after treatment, changes to texture and quality, smoother skin and improvements in fine lines and wrinkles
2. 12 months after- full effects, body will produce new collagen and improve elasticity, tightening, and help even out skin tone 

Broadband Light (BBL)

Targets signs of aging, sun damage, and other skin conditions. BBL can treat brown pigmentation often found in aging spots or freckles. BBL can also target vascular problems such as smaller blood vessels, excess redness, and rosacea. 

• How it works: BBL targets the upper layer of your skin, gently heating it. This heat stimulates your skin cells to regenerate. If your target is redness, the blood vessels will absorb the energy causing them to close off, following treatment your body will reabsorb the destroyed vessels. If you are targeting a brown spot, such as a freckle or liver spot, the laser will target the pigmented particles, breaking them up. 7-14 days after your treatment those spots will peel off.
• How many treatments will you need?: Your treatment should be personalized based on your needs. Typically complete corrections require 3-4 treatments.
• Recovery: After your treatment you will have redness that may feel like a sunburn. Depending on the area of treatment you may experience swelling for a day or two. After vascular treatment you may see what looks like bruising, this is from the blood of the targeted vessels. Be sure to use sunscreen after your treatment as your skin will be more sensitive to sunlight.

Moxi

A non ablative fractional laser resurfacing treatment that can aid in the correction of the initial signs of sun damage and aging by fixing uneven pigmentation and improving the general tone and texture of the skin by way of collagen stimulation. Moxi is designed to treat all skin types. Moxi also works particularly well with younger patients, or those who are just starting their skincare journey, as it is quick, effective, and has a short recovery period. Because it is non ablative, the recovery time for moxi is a lot shorter than say a Fractional C02 treatment. Moxi is a quick procedure that is usually completed within 30 minutes. Moxi lasers produce gentile micro-pulses to induce controlled damage to desired targeted areas. Your body will naturally remove these damaged cells and replace them with new cells, resulting in fresh and vibrant new skin.

Recovery with moxi is very quick, with patients being able to apply makeup as soon as 24 hours after their treatment. 

Erbium (Er:YAG)

Lasers can be ablative or non-ablative. Erbium treatmetns promote collagen remodeling, making them popular options for treating fine lines, wrinkles, skin laxity, and age spots.The Erbium laser emits light that is absorbed by water as the light hits the skin which vaporizes the tissues holding that water. This controlled vaporization of the superficial skin cells leads to collagen remodeling and healing, as it stimulates the formation of collagen which will tighten the skin further. The object is to damage the skin to stimulate it just enough to promote healing. This damage will be similar to a burn and afterwards with potential for the skin to ooze. Deeper wrinkles require more treatment, while shallow scars and wrinkles may be completely erased after just one treatment.

Healing typically takes around a week. There may be mild swelling and inflammation, but it will recede within a week’s time. Keep the area clean, and you may be given an antibiotic ointment.

ND: YAG

Neodymium-doped yttrium aluminum garnet is a crystal that is used as a medium for solid state lasers. This laser works by emitting a high energy wavelength of light which, when focused on certain skin conditions, will create heat and destroy diseased cells. ND Yag can treat a wide range of conditions including vascular lesions, pigmented lesions such as liver spots and freckles , hair removal, and even tattoo removal. The vascular conditions ND yag can treat include, varicose veins, spider veins, facial veins, vascular birthmarks and vascular tumors. 

Maintenance/upkeep after a laser skin resurfacing treatment

After your procedure is completed you will need to keep the treated area clean. You will want to clean the area 4 to 5 times a day, as well as applying an ointment such as petroleum jelly to prevent the area from scabbing over. Depending on your swelling, you may be prescribed steroids to help the swelling. You will likely be itchy in the areas where your treatment took place, this will subside within a few days. Typically 10- 20 days after you start your healing you can start wearing oil free makeup. 

After surgery you should be using a broad spectrum sunscreen as your new skin is more susceptible to sun damage. You want a broad spectrum sunscreen that protects your skin from both UV-A and UV-B rays. You also want to choose a sunscreen with a high zinc oxide content that is at least spf 30. If you can use clothing to protect your skin that is a better option than sunscreen as you don’t have to worry about reapplication. Keep your skin moist with an ointment like petroleum jelly, this will promote your skin to heal and prevent scabs. 

Schedule your laser skin treatment today with milk and honey. 

Milk + Honey offers our clients a wide variety of medspa treatments to help them look and feel their best. Ahead, we take a look at some of our most popular procedures, what they’re good for, and how long the results from the treatment will last. 

Injectables and fillers 

Injectables and fillers are minimally invasive med spa procedures that restore volume and lift the face. These products can be used all over the face to plump, smooth, and minimize the look of moderate to severe wrinkles. Dermal fillers can also be used under the eyes to diminish the look of bags and dark circles. 

How long do injectables and fillers last?

The longevity of dermal fillers and injectables depends on quite a few factors, including the type of filler used, the injection location, and even the patient’s individual metabolism. Some fillers can last anywhere from 6 to 12 months, while others can last up to 5 years. 

For example, Milk + Honey offers a collection of 5 different Juvederm products to treat our client’s specific needs. And while these products all fall under the Juvederm line of soft tissue fillers, their longevity tends to vary as follows: 

• Juvederm Vollure – Up to 18 months
• Juvederm Voluma –  up to 2 years
• Juvederm Ultra –  up to one year
• Juvederm Volbella –  up to 1 year
• Juvederm Ultra Plus – Up to 1 year

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You can’t fight the passing of time. Or at least that’s what the mirror says when you lean in for a closer look at your skin. You might see crow’s feet, forehead wrinkles, sunken cheeks, thin lips, or the dreaded “11s” — those vertical frown lines between the eyebrows.

The good news is, you’re not stuck with those age-related issues. If topical treatments aren’t cutting it, but you’re not ready for invasive surgery, a course of injectables could deliver the youthful appearance you’re craving. Injectables can smooth wrinkles and folds or add definition and contouring, and with minimal downtime to boot.

Before you walk into your dermatology center or med spa, it helps to know more about injectables landscape. There are several treatment options, and they don’t all function in the same way. Read on for the scoop on the types of injectables available, including how they’re used, how much they cost, and what you can expect before, during, and after your treatment.

Injectables and Fillers Overview

What are injectables?

Injectables are a class of anti-aging treatments for the face, neck, and hands. They get their name from the method of application. A dermatologist or aesthetician injects a medicine into the skin as a temporary fix for wrinkles, lines, or the loss of contouring.

There are three types of injectables, each with a different method of action:

• Neuromodulators freeze the facial muscles that cause wrinkles.
• Dermal fillers, explained in more detail below, add volume underneath the skin.
• Kybella breaks down fat deposits, specifically those that build up below the chin.

What are dermal fillers?

Dermal fillers are gel formulations that plump the skin. They can treat various anti-aging complaints, including thin lips, wrinkles and creases, and age-related definition loss. The face is the primary treatment area — lips, mouth, eyes, jawlines, cheeks, nose, and chin. But aestheticians may also use dermal fillers on the backs of the hands, which can also become sunken with age.

Ingredients you might see in a dermal filler include Hyaluronic Acid (HA), Calcium Hydroxylapatite (CaHA), Poly-L-lactic Acid, and Polymethylmethacrylate (PMMA).There is also a procedure that uses fat harvested from the patient’s body as a filler.

6 popular types of injectables and fillers

Botox

Botox is the original neuromodulator. Dermatologists and aestheticians use it to smooth crow’s feet, forehead lines, and creases between the eyebrows.

Xeomin

Xeomin, also a neuromodulator, works like Botox but has fewer inactive ingredients. The manufacturing process strips away unnecessary proteins to isolate the active protein, which is botulinum toxin Type A. Dermatologists believe Xeomin’s additive-free formulation prevents people from developing resistance to the treatment — which can happen with Botox. There is no definitive evidence that the purer formulation produces better or different results, however.

Xeomin is FDA-approved for use on creases between the eyebrows, though aestheticians also use it to smooth crow’s feet and forehead wrinkles.

Dysport

Dysport is also a Botox alternative. Compared to Botox, Dysport is more diluted and spreads out more easily after injection. For that reason, aestheticians may recommend Dysport over Botox for larger areas of the face like the forehead.

Juvederm

Juvederm is a brand of gel dermal fillers made of HA. The Juvederm product family smooths moderate-to-severe facial wrinkles. It can also add volume and restore lost contouring of lips, cheeks, and the area around the mouth.

Restylane

Restylane, like Juvederm, is a brand of dermal fillers. Restylane HA gels can correct wrinkles and folds around the mouth and cheeks. Aestheticians also use Restylane to add volume to the cheeks and lips.

Revanesse Versa

Revanesse Versa is a newer HA filler that’s designed to cause less swelling and last longer than other treatments.  As with Juvederm and Restylane, Revanesse Versa fills in facial wrinkles and folds around the mouth and cheeks.

Injectable and filler areas for the face

Lips

Lips can show aging earlier than other parts of the face. As skin breaks down with age, lips lose definition and start to look thinner. The corners of the mouth can also begin to droop.

HA fillers remedy those issues temporarily by adding volume and definition, directly to the lips or to the area around the mouth.

Cheeks

When you’re young, your face has naturally occurring fat pockets that add shape and contouring to cheeks and other areas. With age, those fat deposits lose volume and can even move — leaving sagging skin behind.

HA fillers can restore the lost volume temporarily, which also corrects sagging skin.

Forehead

Forehead lines and wrinkles develop from repeated movement of the forehead muscles — usually caused by frowning. These can appear in your 20s and become more exaggerated over time, particularly with sun exposure.

Neuromodulators are the injectables of choice for smoothing out forehead wrinkles. Since these formulas freeze the muscle, they can also slow the formation of new wrinkles.

Chin/jawline

Aging-related volume loss in the chin can create an imbalance in facial features. The chin or jawline can appear weak or undefined as a result.

An aesthetician might recommend a dermal filler to restore chin or jawline definition, smooth wrinkles, or even to fill in a cleft chin. For a double chin specifically, Kybella is also an effective treatment.  

How much do injectables and fillers cost?

Neuromodulator injectables are sold in units. The units themselves are inexpensive, but the total price of treatment depends on how many units you need. A targeted treatment might be as low as $75, though most will pay $400 to $500 per session.

Dermal fillers cost more than Botox and its competitors. Depending on the type of treatment and the formula being used, you might pay $525 to $1,000 per treatment.

What to expect during your injectable or filler treatment

Your injectables procedure should always begin with a consultation. That’s when you share your skin concerns with your dermatologist or aesthetician. Based on your input and a skin exam, your skincare professional will recommend a treatment plan.

Neuromodulators

At the time of treatment, your professional will clean your skin. You should not need anesthesia for neuromodulator injections. The pain is minimal — you’ll feel only a small prick. You will need multiple injections, but the exact number depends on the treatment area. You might get four injections to smooth forehead wrinkles, and only two to correct lip wrinkles.

One thing that can be confusing is the difference between a unit of Botox or Xeomin and an injection. To be clear, each injection can include more than one unit of the medicine. For example, you might get 20 units of Botox administered in four shots.

Your neuromodulator treatment should take 15 to 20 minutes.

Dermal fillers

The dermal filler procedure is similar but with two key differences. First, the procedure may take longer — up to 60 minutes, depending on the treatment area. Second, specific to Restylane injections, you may receive a topical anesthesia. Juvederm and Revanesse Versa generally don’t require anesthesia.

Recovery time after receiving injectable and filler treatments

Most people experience minimal to no downtime after their injectable treatments. The most common side effects are swelling and bruising around the injection site. The swelling normally resolves itself within an hour but bruising and soreness can last up to two weeks. For that reason, it’s smart to clear your calendar of any special events for two weeks following your treatment. 

How long do injectable and filler results last?

The smoothing effects of Botox, Xeomin, and Dysport normally last two to four months. Dermal fillers can retain their effectiveness for up to one year.

Which injectable or filler is right for you?

Injectable treatments may seem routine and commonplace, but they are medical procedures. As such, it’s critical to work with a qualified provider who can recommend an individualized treatment plan — and then deliver that treatment safely and effectively.

milk + honey Medical Aesthetics partners with renowned dermatologist Dr. Tyler Hollmig so you receive the highest quality care available. Hollmig, along with a team of Board-certified medical professionals, can skillfully identify the best injectable treatment for your skin and your lifestyle.

Turns out, you can fight the passing of time. Set up a consultation today and get ready to look your best tomorrow!

Age: 29

Skin Type: I would say my skin type is combination. I never drink enough water (though I try!), so it can get dehydrated. I’m prone to hormonal breakouts and depending on the season, my skin can also be pretty sensitive.

Feelings on medical aesthetics pre-treatment: I’ve always had really positive feelings in regards to getting “work” done. Perhaps that’s thanks to many years spent watching The Real Housewives or maybe it’s simply seeing the great results my friends have had with medical aesthetics procedures. Either way, it’s totally normalized to me. If you could wave a magic wand and love the way you look even more, why wouldn’t you? I can love myself and love that these enhancements are available thanks to modern science. And I do!

Walk us through your experience:

To be completely honest, my decision to get Xeomin was extremely last-minute. I was at milk + honey receiving a touch up for my Versa Lip Filler and mentioned to Allison (the amazing Nurse Practitioner at milk + honey) that I’ve always wanted to do something about my 11s. I explained that I (unwillingly) sleep with my forehead scrunched and often wake up with red lines on my forehead from furrowing my brow all night. We talked a little bit about Botox vs. Xeomin vs. Dysport and I ultimately chose Xeomin because it’s newer, doesn’t have the protein encasements or additives, and (let’s be honest) Gwyneth Paltrow had just posted about getting Xeomin on Instagram.

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