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. Terry L. Hand, M.D. |
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Check Out This Months Deals!
HOLLY JOLLY DYSPORT REBATE
Get a Dysport Treatment
Save $50
Mail in rebate valid on treatment received November 1 - December 31, 2011
Be sure to register before your treatment at www.DysportUSA.com
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LATISSE REAL
DEAL REBATE
Brilliant Distinctions Members
Save $25.00
(Net Price - $95.00)
Valid through November 30, 2011
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Elevess Instant Rebate
Hyaluronic Dermal Filler
Instant Rebate
Save $75.00
Buy 1 syringe of Elevass and receive $75.00 off your second syringe
(Net Price - $925.00)
Valid through
December 31, 2011
No registration required.
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Special Procedure Pricing For Nov/Dec
$800.00 (Regular Price- $1500.00)
Fat Transfer To The Hands
|  | I am often asked what options are available for aging hands. Patients complain that their hands have lost fullness under the skin and that they seem "bony". What has actually happened is that with aging the fat volume under the skin naturally begins to diminish. Consequently, the structures under the back of the skin become much more visible.
There are 2 methods to address this problem, fat transfer and using a dermal filler such as Radiesse. I prefer using fat because Radiesse is more expensive (purchased by the cc). I can usually harvest the amount of fat necessary to completely address the aging changes and some of the fat usually survives long term, whereas Radiesse will usually last about a year.
The fat is usually aspirated from wherever a small pocket of nonconspicuous fat exists. Often that site is the thigh, tummy, back of the arm or knee. Such a small amount is taken from the donor area that there is not any sort of irregularity afterwards.
As with any dermal filler or surgical procedure, the patient is asked to refrain from using medications such as fish oil, antiinflammatories or Vitamin E for 2 weeks prior to the procedure. Local anesthesia is injected into the donor area and the hands prior to injecting the fat. I aspirate 10 to 20 cc's of fat from the donor area and inject it into the skin on the back of the hand, carefully molding it.
The hands may be slightly bruised and swollen for several days but no special recovery is necessary after the procedure.
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Ask The Doctor
Time is getting short! What procedure can I do now to be ready for Thanksgiving and holiday celebrations ASAP?!
When time is a consideration and very little ability to tolerate swelling or minimal bruising is a problem, I usually recommend Dysport over Botox because of it's quick onset. Usually Dysport is effective within several days whereas Botox may take up to 10 days. That being said, I have patients that swear they can feel Botox working immediately. Both are great products and the choice to use one over the other is purely patient preference.
Regarding dermal fillers with the least impact for swelling or bruising, I prefer the ones that contain local anesthesia within the product such as Juvaderm XC, Elevesse and Restylane. Without needing to perform a dental block, there is less possibility of bruising although swelling for several days seems to be inevitable. As always, the patient is encouraged to avoid fish oil, antiinflammatories and Vitamin E for 2 weeks prior to injections if possible.
I suggest that any injectable procedure be done at least a week prior to social committments in order to make sure that the result is perfect for your event!
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"As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them."
~John Fitzgerald Kennedy
 November brings several trends in my practice. I tend to see many patients that are preparing to look their best for the holidays. Many of them have little downtime for major procedures and tend to choose more noninvasive procedures with little or no downtime. I also see a patient population that is planning a procedure for the New Year when social commitments are lessened. The third group of patients has time off at the end of the year and chooses to actually have a procedure when work commitments are minimized and more time off is available. In this edition of our newsletter, I am highlighting nonsurgical procedures that are wonderful for an immediate "perk up" and require little time to recover from. As I always advise, make a plan for procedures that you are truly interested in. If surgery is your first choice but time or money makes the procedure impossible, investigate more minor solutions. Sometimes, a filler, laser light treatment or a neuromuscular relaxant such as Botox or Dysport can make a noticeable difference in one's appearance until a surgical procedure is an option. Almost daily, I am asked about all of the options for skin resurfacing. The major concerns I am asked about are "what will make my skin look better?", "what are the downtimes for the different light treatments?" and of course "what are the costs?" This month I address the top ten questions regarding intense pulsed light (IPL) treatment that I perform with the SRA IPL machine at our office.
Since the holidays are upon us, the manufacturers of almost all of the dermal fillers have special offers. Please check the left column for current specials of your favorites. Some have redemption coupons where the company will send you money back after your treatment but some also have immediate rebates available. If you have any questions regarding the rebates or would like to schedule an appointment with me to discuss or inject fillers or Botox , contact Cheri at 461-6742.
One procedure that I have done for many years with great success is fat transfer. In recent years, many of my patients have tended to only utilize hyaluronic acid fillers because of the ease of injection and recovery. For a select group of patients, I still recommend fat injections for several reasons. If the patient would benefit from several or more cc's of fat, the cost factor often makes fat a more reasonable option. The cost is the same for up to 10 cc's of fat compared to the expense of hyaluronic acids that are charged by the cc. Also, a certain percentage of fat tends to survive long term whereas all hyaluronic acid fillers disperse within a year. Fat transfer is often performed on the face and hands. A procedure that I am highlighting this month and have chosen to offer special pricing on until the end of the year is fat transfer to the hands. A description of the procedure is detailed later in this edition. I often come upon articles that are just plain interesting. This month I have included an article that describes a study that demonstrated that the age of an individual was often judged by how homogenous the individuals skin tone tone was. The study was conducted by the University of Vienna in Austria and published by the Journal of Evolution and Human Behavior. If nothing else is gained from reading this abstract, my hope is that most individuals will abandon the need to perpetually tan and expose their skin to the damaging UV rays that cause most facial irregularities in texture and color.
All the best,
Terry Hand, M.D. |
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10 Top Questions About SRA Intense Pulsed Light Treatments
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1) What is photorejuvenation used for?
Photorejuvenation (IPL- Intense Pulsed Light) laser treatments are most commonly used for:
- Lightening and removing "sun spots", "age spots", and brown blotches on the face, neck, chest, hands and other areas of the body
- Lightening and reducing redness, rosacea, dilated blood vessels and "broken" blood vessels on the face, neck and chest
- Helping to control flushing
- It also has a lesser effect of improving skin texture through collagen stimulation and improves pore size minimally by temporarily reducing oiliness
Photorejuvenation, when done properly, almost always consists of a series of 3-5 treatments, usually one every three to six weeks. The benefits of photorejuvenation treatments are achieved with little discomfort and minimal risk.
2) How does the laser treatment improve the appearance of blood vessels, rosacea, and age spots/freckles?
The laser/IPL device emits a range of lightwaves that are then tuned and targeted at hemoglobin (the red blood cells in the blood vessels) or melanin (the brown pigment in freckles and age spots). The light beam passes through the skin and is absorbed by either hemoglobin or melanin resulting in damage to the vessel wall or fragmenting of melanin pigment. These tiny vessels and the melanin pigment are then absorbed by the body, rendering them less visible.
3) How long does it take for laser photorejuvenation treatments to work?
Most people need 3-5 months, which consists of a full series of 3-5 treatments about 1 month apart. You can see some improvement with each treatment, but it's common for your response to be slightly different to each treatment. The more sun damage or redness you have, the more likely you are to need a full five treatments. Some cases of severe redness or brown spots require more than 5 treatments. Expect to see gradual clearing over time. 4) Do IPL Photofacial treatments hurt and how long will they take? There may be mild discomfort during the treatment, but most patients tolerate removal of dilated blood vessels or age spots/freckles and fine lines very easily. The first treatment is usually the "zingiest." As your skin begins to clear, the treatments usually become even more comfortable. Treatments usually take 30-90 minutes, depending on the size of the treatment area.
Dr. Hand will apply a cool gel on the skin being treated. The smooth glass surface of the handpiece is gently applied to your skin and pulses of light flash. You may feel a very slight sting, like the snapping of a small rubber band.
5) What will I look like right after the IPL treatment, and what is the healing time?
For veins, generally, the skin looks slightly redder after the treatment for two to five days. Makeup can be used starting right after the treatment, as long as it is applied and removed very gently. Rarely, there is bruising, which can take 1-2 weeks to resolve. For freckles and age spots, the spots generally look darker for 3-7 days. Crusting can occur, which may last up to ten days. The lesions will then begin to clear and will generally be resolving at one month. Remember, it takes an average of 3-5 treatments to clear age spots. 6) How long will the results from a photofacial last? After the initial 3 to 5 sessions of IPL, most individuals should see significant improvement for at least a year. I often see patients back 6 to 12 months after the initial series to check in and sometimes for a touch up. Special care should be taken to sunscreen and wear hats as sunexposure can repigment the areas we have so carefully treated. 7) How does an IPL treatment increase collagen? The light bypasses the outer layer of skin (the epidermis) and gently heats the cells in the deeper layer of skin (dermis). These cells, called fibroblasts, start to produce more collagen, which improves texture and fine wrinkles. 8) Will the IPL Photofacial treatment make me more sensitive to the sun? No, it does not. You can have the treatments done any time of the year but summer is more difficult if you pick up color easily in the sun. The good effects of the treatments won't last very long if you are getting much sun exposure. You can wear a sunscreen every morning and wear hats to protect your skin and decrease redness, brown spots, wrinkles, and skin cancers. 9) What should I do prior to my photorejuvenation treatment? . - You may be asked to avoid taking aspirin, ibuprofen, or Aleve one week prior to treatment unless medically indicated to help prevent bruising.
- Protect your improved skin with sunscreen every morning. Hats and sunglasses are also good protection from the sun.
- For 2-4 weeks before your treatment, avoid self-tanners and excessive sun.
- You may be asked to discontinue minocycline, tetracycline, doxycycline or Retin-A/Renova several days prior to each treatment
10) Are there any side effects? The main side effects are mild, temporary swelling, redness, an accentuation of the brown spots, crusting, and an occasional bruise or small superficial blister (like a sunburn blister).
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Women's Skin Tone Influences Perception Of Beauty, Health and Age
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A new study is revealing that wrinkles aren't the only cue the human eye looks for to evaluate age. Facial skin color distribution, or tone, can add 10-12 years to a woman's perceived age.
The study, published in the journal Evolution and Human Behavior, used three-dimensional imaging and morphing software to remove wrinkles and furrows from pictures of women, leaving skin tone as the only variable. Researchers were then able to determine exactly what impact facial skin tone has on how young, healthy and attractive people perceive the women to be. Faces with more even skin tone were judged to be younger.
"Until now, behavioral scientists have mostly ignored the overall homogeneity and color saturation of a person's skin," says lead researcher Dr. Karl Grammer. "This study points out that wrinkles aren't the only visual cue to a woman's age."Skin tone and luminosity may be a major signal to suitors of a woman's attractiveness, as well as of her assumed age," said Grammer, who is founder and scientific director of the Ludwig-Boltzmann-Institute for Urban Ethology at the University of Vienna, Austria.
The researchers took digital photographs of 169 Caucasian women between the ages of 10 and 70. Then they used specialized morphing software to "drape" each subject's facial skin over a standardized model, in effect, taking 169 different skin tones and applying them to a common canvas.
In the process, other potential age-defining features such as facial furrows, lines and wrinkles were removed, leaving skin tone as the only variable. Then, these models were viewed by 430 observers who were asked to estimate each model's age and gauge her health and attractiveness.
The models who had the most even skin tone received significantly higher ratings for attractiveness and health, and were also judged to be younger in age. The models with uneven, blotchy skin tone were judged to be significantly older. "Whether a woman is 17 or 70, the contrast of skin tone plays a significant role in the way her age, beauty and health is perceived," says study co-author Dr. Bernhard Fink. "An even skin tone can give visual clues about a person's health and reproductive capability, so it is considered most desirable."
Fink, a senior scientist in the Department for Sociobiology/Anthropology at the University of Goettingen, Germany, said the work is important for women considering efforts to improve their tans. "We found that cumulative UV damage from too much sun dramatically influences skin tone, giving women yet another reason to prevent future UV-related skin damage or try to correct past sun damage."
The researchers said that tone variances could be caused by several factors including cumulative UV damage (freckles, moles, age spots), natural aging (yellowing, dullness) and skin vascularization (redness). Not surprisingly, the study hinted at a positive correlation between the amount of accumulated photodamage and the amount of uneven skin tone.
Next Phase of Tone Research - Getting Under the Skin As a next step, Drs. Grammer and Fink will partner with scientist and skin imaging expert Dr. Paul Matts, from P&G Beauty (a division of Procter & Gamble that funded the study) to look at the distribution of 3 chromophores - melanin, hemoglobin, and collagen -- in the skin of study subjects and correlate this distribution with perceived attractiveness. A non-invasive imaging technology called SIAscopy--originally developed by UK-based Astron Clinica for early skin cancer detection--will help the scientists study the chromophores. These 3 chromophores directly affect how the human eye perceives qualities such as luminosity in young skin or dullness in aging skin. "Because skin has optical depth, our eyes perceive discolorations on the surface and in underlying layers. This discoloration can be subtle or overt. We believe the judgment of facial skin age is influenced by uneven chromophore distribution and a decrease in light reflection," says Grammer.
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| 6 Month Interest Free Financing Is Still Available | 
2011 has brought new government rules regarding financing. CareCredit has refined it's programs and has a new option that will benefit most of our patients. In the past, our office offered a 3 month same as cash option for payment. Carecredit has revised the program so that the repayment period is now extended to 6 months, same as cash! There is no longer a minimum charge amount to qualify for this offer.
Credit lines up to $25,000 are available with instant qualification and credit availability. A payment plan that gives you 6 months to pay for your procedure with no interest charges may be selected. A secure CareCredit application may be found on the financing page link below. Click on the blinking "Learn More About CareCredit" button. Most applications are approved in several minutes.
Please let Cheri or Lisa know if you need any further clarification regarding the current financing options with CareCredit.
As always, our office continues to accept Visa, Mastercard and personal checks as well.
View the CareCredit payment calculator and application |
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THANK YOU!
| Once again, thank you for reading our newsletter! As always, subscribers to this letter are free to come into the office for a no charge consultation regarding surgical or cosmetic procedures. Please give Lisa or Cheri a call at 415-461-6742 for any questions or if you would like to meet with Dr. Hand. We will look forward to hearing from you!
Schedule a consultation with Dr. Hand
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