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Posts for category: Services

By Dr. Alex Eshaghian, MD, PhD
February 17, 2019
Category: Services

There are many cosmetic treatments available for rejuvenation of the face and neck. Here we will discuss treatments to address specific concerns with the lower face and neck.

What changes occur in the lower face and neck over time?

Liquid Facelift before and afterThe majority of changes associated with aging in the lower face result from loss of collagen and volume loss. Collagen is the protein that keeps the skin firm, tight, and youthful in appearance. Over time and with sun damage, we lose collagen. It is broken down faster and we make less of it. Also, the bone structure in the face changes. For example, the bones in the upper cheeks move downward and inward. At the same time the fat pads in this area move downward. Together this leads to a descent of the lower face. We start to see laugh lines (from the sides of the nose to the corners of the mouth) and sometimes they continue to the jawline as marionette lines. Loose skin and wrinkles are seen in the lower face and neck. The jawline definition is also reduced as we see the formation of jowls.

Restoring Volume in the Mid-Face

Voluma before and afterVoluma is a filler that is used to restore lost volume in the mid-face. Voluma is placed on the upper cheek bones and provides and immediate volumizing and lifting effect. Voluma will restore the youthful apple of the cheeks and pull up on the lower face to address many of these changes seen as we age. The active ingredient in Voluma is hyaluronic acid, a naturally occurring sugar found in the skin that draws water into the area to provide volume. You will see your results with Voluma right away and enjoy these results for one to two years depending on how much product is used.

Creating More Collagen

There are a number of ways to create more collagen in the skin. First it is important to use good skin care products to protect your skin. This includes daily sunscreen along with products such as retin-A and vitamin C, which stimulate collagen formation and protect your skin from damage. Treatments such as laser skin tightening and Ultra Microneedling will help this even more. These treatments stimulate your body to produce its own natural, new, fresh, and healthy collagen. This helps with wrinkles and loose skin. It will pull the skin from above and below, providing a natural lift.

Treating Wrinkles in the Lower Face

Volbella before and afterMarionette lines and fine lines around the mouth can be treated with fillers. Vollure is an outstanding product that provides natural and long-lasting results for the laugh lines and marionette lines. Vollure can also be used to volumize the lips. Fine lines around the mouth are best treated using Volbella, another filler that works well to fill in the small lines without providing much volume.

Getting Rid of the Double Chin

Kybella before and afterKybellla is a great treatment to get rid of the double chin. Kybellla is the first and thus far only FDA-approved, non-surgical, injectable treatment for the double chin. The active ingredient in Kybellla is a salt found in the body that is used to digest that fat that you eat. When Kybellla is placed in the skin Kybellla will dissolve the fat and it’s naturally eliminated by the body over time. Most people have two to four session Kybellla spaced every three months. A series of laser skin tightening treatments between the first and second Kybellla sessions will give even better results.

Defining the Jawline

Voluma chin before and afterSome people have a weak chin or jaw bone. Fillers such as Voluma can be used to enhance a weak chin and the corner of the jawline. This provides a natural result and can make the face look more balanced. Also, Botox can be used in what is called the Nefertiti Neck Lift to relax the muscle in the neck. This muscle pulls down on the lower face. When relaxed with Botox, it will provide a natural and subtle lift to the lower face to complement the other treatments described here.

Combining Treatments

Rather than simply having one treatment done, most people find that they get the best results when combining many or all of these treatments. These combinations address all of the different aspects associated with aging: volume loss, collagen loss, buildup of fat under the chin, and relaxing muscles.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
February 03, 2019
Category: Services
Tags: Vollure   Juvederm Vollure  

Vollure before and after lips IMLip enhancement using fillers has been very popular over the last decade. Initially a significant increase in lip size was most desirable. However, over the past few years women (and men) are desiring more subtle and natural results. Now with Juvederm Vollure we are able to provide an enhanced appearance of the lips without looking like your lips have been done.

What are fillers?

Fillers, or dermal fillers, are products that are placed in the skin to restore volume. There are many different types of products and they can go in different places. The most common fillers are those that use hyaluronic acid as their active ingredient. Theses include the products in the Juvederm collection (Juvederm Voluma, Juvederm Vollure, and Juvederm Volbella), Restylane, Belotero, and Revanesse Versa. Hyaluronic acid is a naturally occurring sugar found in your skin that draws water into the area to fill in wrinkles and folds. These are the safest products because they can be reversed if the results are not what you wanted or if there are any side effects. For this reason, Dr. Alex only uses hyaluronic acid fillers. Other non-hyaluronic acid fillers include Radiesse, Sculptra, and Bellafill.

Vollure before and after lipsDepending on the person, fillers such as Juvederm VolumaJuvederm Vollure, and Juvederm Volbella can be placed in different areas. Common areas of treatment include the temples, eyebrows, nose, under eye area, cheeks, laugh lines, marionette lines, chin, jawline, and hands. And different products work well for different areas. For example, Juvederm Voluma is a very firm product, making it ideal for lifting and filling certain areas such as the temples, nose, cheeks, chin, jawline, and hands. Juvederm Volbella is very soft, making it perfect for fine lines around the lips. Juvederm Vollure is in between and works well for eyebrows, under eyes, and lips.

What is Vycross technology?

Vycross technology is what is used in the newer products in the Juvederm collection: Juvederm VolumaJuvederm Vollure, and Juvederm Volbella. It has to do with the chemistry of the product and how it is made. There are different sized hyaluronic acid molecules in these products and there is more cross-linking. This allows for two different things. First, a lower concentration of the active ingredient (hyaluronic acid) is needed, so there is less swelling after the treatment and the results look more natural. Second, you will enjoy your results longer with these products. These are the reasons that Dr. Alex exclusively uses Juvederm VolumaJuvederm Vollure, and Juvederm Volbella at A E Skin.

What fillers work best for the lips?

When fillers first became available, they were initially used for the laugh lines that go from the sides of the nose to the corners of the mouth and the marionette lines that continue from the corners of the mouth to the jawline. Over time these products have been used in other areas. One of the most popular areas has been the lips. At first everyone wanted larger and larger lips. But after several years, people starting learning more about fillers and Botox and found that it can look like the lips are too big. Nowadays, people still want to enhance the appearance of their lips, but they want it to look more natural. Juvederm Vollure is an outstanding product for just this. The woman shown in the pictures here received one syringe of Juvederm Vollure in her lips. You can see in the before and after photographs shown here, the size and shape of the lips are enhanced without looking like a duck. Also, you can see that the fine vertical lines on the lips are improved. This is because the product hydrates the lips. And because Juvederm Vollure uses Vycross technology, she will enjoy her results for a year or more.

How does a Juvederm Vollure treatment work?

Treatment with a filler such as Juvederm Vollure is very easy. After taking baseline photographs to monitor your progress, we will numb you lips with cream for about 15 minutes. Then the area is cleaned with special cleansers to prevent infection. Juvederm Vollure is placed in different areas in the lips depending on your concerns using a needle. After your Juvederm Vollure treatment, swelling is usually seen and is normal. We will provide you with an ice pack to help reduce any swelling. If you get a bruise from your Juvederm Vollure treatment, we can treat it with a laser as early as the next business day. We also now have the anti-bruise pads to further decrease the risk of bruising. Bruises will go away on their own in about two weeks after a Juvederm Vollure treatment and the laser treatment makes them go away in one to three days. You’ll see your final results in two weeks when you return to the office for your after pictures. At that time, you can receive more Juvederm Vollure if you want further enhancement. After the Juvederm Vollure treatment, please avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours to reduce the risk of bruising. To decrease the swelling after a Juvederm Vollure treatment, apply ice packs on and off for five minutes at a time as much as possible for a few days, try to sleep on an extra pillow, and avoid salty foods for a few days. The best thing about a Juvederm Vollure treatment is that you will see the results right away.

Vollure for the Lips Demonstration

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
January 20, 2019
Category: Services

happy womanFor many years we have been using laser technology to address a variety of concerns on the face. Now we are able to use laser for feminine rejuvenation.

What is feminine rejuvenation?

Feminine rejuvenation is a new are of focus for many cosmetic physicians. The face is most commonly treated area on the body in the field of aesthetics. Common concerns include undesired wrinkles, uneven color, and loose skin. But the face is not the only area of the body that undergoes changes over time. Age, childbirth, and hormonal changes over time have an effect on feminine health. Changes include looseness of the skin around the vagina and the internal muscles. This leads to an aged appearance as well as other functional changes such as stress urinary incontinence (SUI). SUI is a condition where women leak urine when they laugh, cough, sneeze, exercise, or bear down. It results from loosening of the pelvic floor muscles, especially after childbirth. Additionally, with menopause hormonal changes include dryness, which can lead to itching and pain with intercourse, as well as decreased sensation in the area, resulting in decreased pleasure with intercourse and a decreased desire for intimacy. All of these changes are of course unwanted. Fortunately, we are now able to reverse these changes using laser technology for feminine rejuvenation. The feminine rejuvenation treatment tightens the skin, the internal muscles, and increases lubrication. This results in a more youthful and rejuvenated appearance, improvement in SUI, increased pleasure with intercourse, and an increased self-confidence.

How does feminine rejuvenation work?

The feminine rejuvenation treatment is very simple. Similar to laser skin tightening, gentle micro-pulses of infrared light are used to slowly heat the entire area around the vagina. The treatment is entirely external and there is no penetration. The heat penetrates deep into the skin and tissues, resulting in a number of changes. The skin on the outer surface is stimulated to form new, fresh, and healthy collagen, which tightens the skin and provides a more youthful appearance on both the labia majora (outer lips) and labia minora (inner lips). The muscles on the inside are stimulated. This results an in increase in strength of the pelvic floor muscles which helps with SUI. At the same time the muscles in the vagina are also strengthened, resulting in increased pleasure with intercourse. The other benefit of the deep heating of the tissue is that it draws more blood to the area. This allows for increased lubrication, which decreases itching and pain with intercourse.

What is involved in the feminine rejuvenation treatment?

The feminine rejuvenation treatment is a simple non-surgical treatment that can be done during your lunch break. The feminine rejuvenation treatment itself is fast, safe, and comfortable. The area is first cleaned with a cleansing solution. Then ultrasound gel is applied to the area to allow for the light to be transmitted. The laser is passed over the entire region, one small area at a time, for about 15 minutes total. It feels like a warming sensation and numbing is not required. Dr. Alex recommends that the area is shaved the morning of the treatment or the day before the treatment for best results.

Feminine Rejuvenation Demonstration

Warning: Graphic Content

How many feminine rejuvenation treatments will I need?

Dr. Alex recommend an initial series of three feminine rejuvenation treatments at one-month intervals. After that, patients have one maintenance treatment every six to twelve months.

What should I do after a feminine rejuvenation treatment?

There is no recovery after a feminine rejuvenation treatment. You can resume your normal activities right away. The are may be hot, red, and swollen for a few hours. But there is no recovery after that. You can resume intimacy right away.

Am I a good candidate for feminine rejuvenation?

There are many women who are good candidates for the feminine rejuvenation treatment. Some women simply want a more youthful appearance of the external structures to improve wrinkles and loose skin. Others suffer from SUI, dryness, decreased sensation, pain with intercourse, and decreased pleasure. Often times this occurs after childbirth, especially multiple children, and after menopause. All of these women are great candidates for the feminine rejuvenation treatment.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
January 13, 2019
Category: Services
Tags: Botox  

Botox for TMJBotox is one of the most popular treatment in our office. Botox is most commonly used to treat wrinkles on the face. However, Botox can also be used for a number of other purposes that are not cosmetic.

What is Botox?

Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment with Botox are in the upper face. These include the horizontal lines seen on your upper forehead when you raise your eyebrows, the vertical lines seen between your eyebrows when you frown (frown lines), and the crow's feet seen around your eyes when your smile.

Botox for TMJ pain

Many people grind or clench their teeth. This can result in pain in the TMJ joint in front of the ear. Botox can be placed in a muscle in the lower face used for biting called the masseter to contour the lower face and address pain associated with TMJ. In this area 20-40 units of Botox are used per side. Depending on the reason for the enlargement of the muscle, permanent results may be achieved using Botox. For example, some people have a habit of grinding, clenching, or biting their teeth subconsciously. Often times this happens in their sleep when they are not aware of it. Botox placed in this muscle will relax the muscle and the grinding, clenching, and/or biting will decrease. This will reduce the size of the muscle. If the brain gets accustomed to this and the person stops grinding, clenching, or biting, then the muscle will not become enlarged or as enlarged again. However, if the habit starts again, the muscle will likely get larger.

To determine if you are a good candidate for this Botox treatment it is necessary to look at your lower face when biting and comparing it to when you are not biting. If a bulge is seen on the outer portion of the jawline, then you are likely a candidate for a Botox treatment. It can also be felt with the fingers when biting.

The picture shown here is that of a patient who had a Botox treatment for her TMJ pain. Botox also slims the lower face, making it look like she has lost weight.

Botox for Migraine Headaches

Botox works to treat migraine headaches in the same way it works to treat wrinkles: by relaxing muscles. In the case of migraine headaches (and sometimes other headaches such as tension headaches) the muscles in the upper face and head contract. This puts pressure on the bones which can be very painful.  Botox will relax the muscles to relieve the pain. The areas treated with Botox for migraine headaches are those treated in the upper face. Sometimes additional muscles are also treated with Botox such as those in the temples and back of the head. The dose of Botox used is in the range of 60 to 70 units. Full results are seen in two weeks and after a Botox treatment. However, many patients feel improvement as early as the next day after a Botox treatment.  Botox treatment for migraines will significantly reduce the frequency of migraines and is a great alternative for those for whom oral medications are ineffective. Most people enjoy their results from a Botox treatment for three to four months. At that time a maintenance treatment is recommended. A video demonstration of this treatment is shown below.

Botox for Migraine Headaches Treatment Demonstration

Botox for Enlarged Pores

One of the side effects that people notice when they get Botox to treat their wrinkles is an improvement in the appearance of the pores. The Botox can also decrease production of oil in the glands to reduce the size of the pores and to treat oily skin. For such a purpose Botox is used slightly differently. The Botox is diluted more than normal and spread out over the skin surface. Therefore, there are many injection points rather than just a few. Also, the Botox injections are placed in the very surface layers of the skin so that it can best reach the oil glands, in contrast to deeper placement of Botox when used to relax muscles. Usually about 40 units of Botox are used for the entire face. The results of such a Botox treatment are seen in a few days and most people enjoy their results for three to four months.

Botox for Excessive Sweating 

Excessive sweating, a condition known as hyperhidrosis can be a serious concern for some people. Excessive sweating can occur even when it is not hot. It sometimes occurs when a person is nervous. This can become very embarrassing for a person, especially when it happens frequently. The most common areas of concern include the underarms, palms of the hands, and soles of the feet. Fortunately, Botox is an easy and effective treatment for excessive sweating. These areas are more sensitive and therefore numbing cream is usually applied on the area for about 15 minutes prior to the treatment. To determine exactly where the sweat glands are, sometimes a test is performed called the starch iodine test. Iodine is placed on the area of the skin which will be treated. The areas with more sweat glands will appear dark. This allows the provider to know exactly where to place the Botox. Despite this, typically the entire area is treated and the Botox is placed to cover the entire area. Usually 50 units of Botox are used on each side. Some people enjoy their results from a Botox treatment for six months or more. Similar to when Botox is used for cosmetic purposes, periodic maintenance treatments are required.

Botox for the Scrotum

One of the newest and also most controversial uses for Botox is for scrotal enhancement. The scrotal sac needs to be slightly colder than body temperature for sperm production. Normally the sac hangs below the body to provide a slightly colder temperature. There is a muscle in the scrotal sac which is used to pull the scrotum toward the body. This muscle contracts normally in cold weather so that the scrotum is not too cold. When this muscle contracts the sac appears wrinkled. When this muscle is relaxed with Botox these wrinkles are not seen since the muscle does not contract. Therefore, it is not able to function appropriately for temperature regulation and sperm production may be abnormal. This is important for men who are trying to have children. The other benefit of placing Botox in this area is that, similar to the underarms, palms of the hands, and soles of the feet, Botox will reduce sweating in the area.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
January 06, 2019
Category: Services

Ultra Microneedling before and afterMicroneedling has become a very popular treatment. With Ultra Microneedling even better results can be obtained without a shorter recovery.

What is microneedling?

Microneedling is a new technique to achieve better looking skin. Traditionally, some sort of small needle is used to create tiny holes in the skin. This stimulates the healing response in your skin to make more collagen, the protein that keeps the skin tight, firm, and youthful in appearance. Slowly over time with a series of treatments you will notice improvements in the texture, fine lines, wrinkles, uneven color, and even scars.

There are many versions of microneedling treatments. Some are done in the office and some can even be done at home. Some devices are rollers which create holes while moving along the skin. If the needles are small enough they can be used at home. Those with longer needles need to be done by a professional since they go deeper. Sometimes numbing cream is applied before the treatment to make it more comfortable. Some devices look like a pen and the needles go in and out. Sometimes the depth can be adjusted depending on the person.

Microneedling with Radiofrequency

Some devices are even more sophisticated because they add radiofrequency to the needles. With these systems such as Endymed, Venus Viva, Infiny, and Vivace, the tips produce radiofrequency which heats the deeper layers of the skin. The benefit of this is that you get even more collagen stimulation.

What is PRP?

PRP is short for platelet rich plasma. PRP is obtained by first drawing blood and then separating it by spinning it for about ten minutes. This separates the red blood cells, white blood cells, and plasma. The plasma is rich in a certain type of cell called platelets and it contains a high concentration of growth factors. These growth factors help with the healing process. Adding PRP is more involved since your blood needs to be drawn and processed. Then the PRP is placed on the skin either while the needles are penetrating the skin (allowing it to be pushed in the skin) or immediately after once there are holes in the skin where they can penetrate. The main benefit of adding PRP is that the recovery time is shortened and you get a glow for a few weeks.

Some offices use something called PRF, which is short for platelet rich fibrin. This is a slight modification of PRP which some people find to provide even better results.

What is the recovery after a microneedling treatment?

When needles are used to create holes in the skin, bleeding can be seen, especially when the needles are longer. Sometimes when radiofrequency is added, the heat decreases the amount of bleeding seen. When PRP is added on the skin it becomes even more red. Often times the redness and swelling lasts for several days after the treatment. You have to stay out of the sun and you can’t apply makeup.

What is Ultra Microneedling?

Ultra Microneedling is a treatment designed by Dr. Alex to provide even better results than that from traditional microneedling with or without radiofrequency and with or without PRP or PRF. With Ultra Microneedling, Dr. Alex uses a laser technology to create the holes. This has the benefit of more precision and a faster treatment. The Ultra Microneedling treatment usually takes two to three minutes while traditional microneedling usually takes 15 to 30 minutes. The other benefits of Ultra Microneedling are due to the laser itself. The laser produces even more heat than radiofrequency, so there is absolutely no bleeding and the results are even better. At A E Skin we apply a hydrating sheet mask on our patients for about 15 minutes after an Ultra Microneedling treatment. After this you can hardly tell you had a treatment done. You can resume your normal activities right away and apply makeup the next day. v uses conservative settings at your first Ultra Microneedling treatment to make sure your skin reacts appropriately. On the second Ultra Microneedling treatment the settings can be increased depending on the individual person. Dr. Alex recommends a series of six monthly Ultra Microneedling treatments followed by one maintenance Ultra Microneedling treatment every three months after that. In the before and after picture shown here the patient had five Ultra Microneedling treatments. It looks like she has had fillers or even a facelift. These are the additional benefits people enjoy from Ultra Microneedling as compared with traditional microneedling. Dr. Alex often combines the Ultra Microneedling treatment with an IPL photofacial treatment to further address irregular color. This combination is called the #nofilter treatment and is quickly becoming one of our most popular treatments.

Ultra Microneedling Treatment Demonstration

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
December 30, 2018
Category: Services
Tags: Voluma  

Voluma to enhance a weak chinA common concern for many patients is a weak chin. Traditionally, surgery has been performed for correction. We now have non-surgical options that provide outstanding results.

What is a weak chin?

A weak chin described the condition where the chin is not balanced with the rest of the face. This has to do with the anatomy of the face. There are many bones in the face that provide the structural support. In the lower face, there is a bone that provides support for the upper teeth and another that provides support for the lower teeth and chin. In some people the lower bone does not project forward enough, making the position of the tip of the chin behind that of the upper lip. This makes the chin appear out of balance with the rest of the face.

How can a weak chin be treated?

Now with the use of fillers we can treat a weak chin without surgery. Fillers are used to restore lost volume in the face and in other places of the body. The filler that works best in this area is Voluma. Voluma is a filler in the Juvederm family that works well to volumize and restructure the face. The active ingredient in Voluma is hyaluronic acid, a naturally occurring sugar found in the body. Hyaluronic acid draws water into the area to provide volume and structure. Depending on the person and their individual appearance, different amounts of product can be used. The patient shown here received two syringes of Voluma to enhance her weak chin. Now the chin appears balanced with the rest of her face. Small changes wuch as this can make a big difference in a person’s appearance. The best thing about Voluma is that people will enjoy their results for two years or more in this area.

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
December 16, 2018
Category: Services

Forever Young BBL IPL photofacial before and after for rosaceaA common concern for patients is redness on the skin. Often times the redness is caused by rosacea. Fortunately, we have an outstanding treatment to control rosacea.

What is rosacea?

Rosacea is a condition characterized by the appearance of redness on the face. This usually occurs in the central face on the nose and cheeks, but for some people it can spread to the entire face and even down to the neck. Sometimes you see generalized redness on the skin and in some people, you can see broken capillaries, particularly on the nose and cheeks. In some cases, bumps appear, making it look like acne; and sometimes rosacea is confused with acne. People with rosacea tend to have sensitive skin. With rosacea there are triggers that lead to the redness. Everyone is different, but common triggers include sun exposure, heat, cold, eating spicy food, drinking alcohol, and emotional stress.

How is rosacea treated?

Rosacea is a chronic condition that is controlled, not cured. The first thing to do is to identify the triggers for the individual and avoid them. Sunscreen is important for all patients with rosacea because the radiation from the sun can make everything worse, even if it is not a trigger. Dr. Alex recommends a sunscreen with SPF at least 30 every day. Rosacea patients love the Elta MD UV Clear sunscreen because it contains an ingredient called niacinamide. This is a vitamin B derivative which helps to reduce redness. Treatment for rosacea involves targeting the blood vessels in the skin. This can be done with lasers. Dr. Alex combines the Forever Young BBL IPL photofacial with a laser skin tightening treatment. This combination is called the Tight and Bright Rejuvenation. The light from this treatment is absorbed by the blood in the skin and destroys the blood vessels in the skin. Overall patients see a significant reduction in redness and broken capillaries. Dr. Alex recommends an initial series of six monthly treatments followed by a single maintenance treatment every three months after that.

Tight and Bright Rejuvenation Demonstration

 

Tight and Bright Rejuvenation Patient Testimonial

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
November 04, 2018
Category: Services
Tags: Botox  

Botox to contour the lower faceA slim face is a feature of youth and beauty. Over time the structures of the face change. Fortunately, we can reverse some of these changes with Botox.

What is Botox?

Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment with Botox are in the upper face. These include the horizontal lines seen on the upper forehead when you raise your eyebrows, the vertical lines seen between the brows when you frown (frown lines), and the crow's feet seen around your eyes when you smile. Full results are seen two weeks after a Botox treatment and most people enjoy their results for three to four months.

What is the ideal facial shape?

The ideal shape of a face depends on a number of things. First it is different between men and women. And second, there are some differences from culture to culture. In the United States, the ideal shape for a female is that of a heart. In a heart-shaped face the mid-face is widest where the cheeks project outward near the ears and the lower face tapers down to a point at the chin. In men, on the other hand, a square lower face with a well-defined jawline is more desirable.

What changes the shape of the face over time?

There are many things that affect the shape and appearance of the face which change over time. As mentioned, the cheeks should be prominent. Over time the fat pads in the cheek get smaller and the cheek bones move downward and inward. These make you lose the projection in the cheeks. At the same time, we lose collagen in the skin. Collagen is the protein that keeps the skin tight, firm, and youthful in appearance. Over time we stop making as much collagen and it is lost. This leads to loose skin, wrinkles, and sagging, making the face look like it is sinking down. In some people, especially those who clench or grind the teeth, a bulge can appear in the lower face, making the lower face appear wider. This is a result of using the muscle that sits in the lower face which is used to bite.

What can I do to slim my lower face?

There are a number of things you can do to slim the lower face. First fillers such as Voluma can be placed in the upper cheeks, restoring the projection and lifting the lower face. Also, laser skin tightening treatments can be done to stimulate the formation of collagen. This will tighten the skin and lift the face. Another simple treatment for those with a bulge in the lower face is with Botox. Botox works by relaxing muscles. In the upper face, when you make facial expressions you are using the muscles. Over time this leads to the formation of wrinkles such as frown lines and crow’s feet. When the muscles in the upper face are relaxed with Botox these wrinkles smoothen out. In the same way, Botox can relax the muscle that is used for biting. When relaxed it becomes smaller, making the bulge less visible. This slims the lower face. This is the treatment the patient shown here did. She got a slim lower face and she looks like she has lost weight. At the same time she no longer has pain associated with grinding of the teeth.

Botox Demonstration to Contour the Lower Face

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

By Dr. Alex Eshaghian, MD, PhD
October 21, 2018
Category: Services

laser skin tightening neck before and afterDo you have loose skin or wrinkles on your neck that concern you? With laser skin tightening you can get rid of those wrinkles to have a youthful and smooth neck.

How to wrinkles form on the neck?

As we age there are many changes that occur in our body and on the skin. The body slowly decreases the amount of collagen that it produces. Collagen is the protein in the skin that keeps it firm, tight, and youthful in appearance. When collagen levels decrease the skin becomes loose and wrinkles are seen. There are other factors that can contribute to this appearance as well. Sunlight damages the skin and destroys the collagen. Therefore, it is important to protect the skin on the face, neck, and entire body with sunscreen every day. Dr. Alex recommends using a sunscreen with an SPF of at least 30 with UVA and UVB protection. Smoking also affects the skin in the same way, leading to wrinkles. It is also important to maintain a healthy lifestyle by drinking enough water every day, getting enough sleep, and exercising regularly. These activities will prevent wrinkle formation.

How can I treat wrinkles on my neck?

Laser skin tightening is an easy, non-invasive, and no down-time way to significantly reduce the appearance of wrinkles on the neck (and in other places) without surgery, incisions, or anesthesia. Laser skin tightening works by using gentle micro-pulses of infrared light to slowly warm up the deeper layers of the skin. This tells your body to form its own natural, new, fresh, and healthy collagen. As a result, the skin will appear smoother and more youthful. The laser skin tightening treatment is very easy. You don’t even need any numbing cream. The skin is first cleaned and gel is applied to transmit the light. You will be given protective goggles or glasses for your eyes. The laser skin tightening treatment takes about ten minutes and is very comfortable. Dr. Alex recommends an initial series of six to eight laser skin tightening treatments. The laser skin tightening are performed every one to two weeks.

When will I see results and how long will they last?

The laser skin tightening leads to the formation of collagen. But collagen does not grow overnight. Just like the wrinkles did not appear right away, they will not go away right away. Results are seen slowly over the course of the laser skin tightening sessions. You will see full results approximately three months after you last laser skin tightening treatment. After the initial series of six to eight laser skin tightening sessions, Dr. Alex recommends a single laser skin tightening treatment every three months to maintain your results and to protect your investment. The patient shown here had five laser skin tightening treatment sessions.

Laser Skin Tightening Demonstration

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

 

By Dr. Alex Eshaghian, MD, PhD
October 07, 2018
Category: Services
Tags: Botox   neck  

Botox before and after for neck bandsVertical bands on the neck can often be seen slowly over time as we mature. Botox is an easy solution for these bands.

What is Botox?

Botox is a purified protein used to address wrinkles that are associated with facial expressions. These include the horizontal lines seen on the upper forehead when we raise our eyebrows, the vertical lines seen between the eyebrows when we frown, and the crow’s feet seen around the eyes when we smile or quint. When placed in the skin, Botox will relax the muscles and smoothen out the overlying wrinkles.

How does Botox work on the neck?

A common concern on the neck is what are called vertical neck bands. These are caused by contraction of a muscled in the neck just under the skin called the platysma. They can be seen or accentuated when the neck is contracted, often times by slightly lifting the chin and moving the lips to show your lower teeth as seen in the photograph shown here. Just like any other muscle on the body, over time the more it is used the stronger it gets. This leads to muscle definition, which is seen as neck bands. Botox works for neck bands in the same way it works for frown lines, forehead wrinkles, and crow’s feet: by relaxing muscles. In this case Botox relaxes the platysma muscle in the neck, preventing it from contracting and forming the bands. The results from a Botox treatment for neck bands are outstanding. Usually 10 units of Botox are used in each of the four bands, for a total of 40 units of Botox.

Additionally, Botox can be used in the neck for what is called the Nefertiti neck lift. Nefertiti was an Egyptian queen known for her long and beautiful neck. In the Nefertiti neck lift Botox is placed just under the jawline from one side to the other side. This relaxes the upper part of the same platysma muscle that is treated for vertical neck bands. When this part of the muscle contracts it pulls down on the lower face. Once it is relaxed with Botox it is unable to pull down on the lower face. This provides a subtle lift of the lower face and improves jawline definition. Sometimes a small amount of Botox is placed in a muscle called the DAO in the lower face. This muscle goes from the corners of the mouth to the jawline and when it contracts it pulls down the corners of the mouth. When the DAO muscle is relaxed with Botox the corners of the mouth are elevated about one or two millimeters. This really helps with a sad face appearance. The Nefertiti neck lift can be complemented by placing fillers in the mid-face, laser skin tightening, and Kybella for the double chin.

Botox for Neck Bands

When will I see the results of by Botox treatment?

Although some people notice the results of their Botox treatment in a few days, it can take up to two weeks to see the full results of your Botox treatment. Therefore, patience is important. We take baseline photographs of you making facial expressions before your Botox treatment and have you return tow to three weeks later to take the same pictures. If you receive the recommended dose of Botox and the results are not perfect, we provide complimentary additional Botox units. This way you don’t have to worry about the possibility of diluted Botox.

How long does Botox last?

Most people enjoy the results of their Botox treatment for three to four months. Dr. Alex recommends a maintenance Botox treatment at that time. We participate in the Brilliant Distinctions Program. This is a rewards program designed by Allergan, makers of Botox, Juvederm, Voluma, Vollure, Volbella, Kybella, and Latisse, where you get points for each treatment. These points are then used toward discounts at your next Botox (or other) treatment.

What are the side effects of Botox?

With any injection there are risks including pain, bleeding, bruising, redness, swelling, infection, and tenderness. We take special precautions to minimize these risks. Dr. Alex uses a painless Botox injection technique where cold air is blown on the skin to numb the skin. We also place a vibrating distractor called the Beauty Bar nearby for further comfort during your Botox treatment. Bruising is rare with Botox treatments and bruises can last up to two weeks after a Botox treatment. If you get a bruise after a Botox or other treatment we are able to treat it with a laser as early as the next business day. This makes the bruise go away much faster, typically in one to three days, although it may still last two weeks and sometimes it gets darker before getting lighter. Headaches can occur for up to a few days after a Botox treatment. Dr. Alex recommends taking over-the-counter strength Tylenol for pain relief. There is also a very small risk (less than one percent) that some of the Botox spreads to nearby muscles. Depending on the area treatment, the spread of Botox make lead to things like droopy eyelids or an asymmetric smile. Such side effects are always temporary and often times treatable.

What should I do after a Botox treatment?

After a Botox treatment, Dr. Alex recommends avoiding heat exposure, alcohol consumption, and strenuous exercise for 24 hours and maintaining an upright posture without bending forward or lying flat for four hours. These activities can lead to the movement of Botox, leading to side effects, and/or increase the risk of bruising.

Patient Review - Botox

Patient Review - Botox

 

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[Dr.] Alex was my first and only Botox doctor and he was very good to let me know know it was OK and to not be nervous. He did a great job and my Botox has laster well over 3 months. And now I am hooked. 

    — Victoria S.

 

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Real SelfI had a wonderful experience I'm 33 years old and I had Botox for the very first time I was so scared but after he explained it to me the painless procedure, NOW that was quite the experience I highly recommend Dr.Alex he is amazing and trustworthy not only that the stuff is very friendly. Thank you so much Dr. Alex

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GoogleI was referred to Dr. Alex by friend. At first I was afraid of getting Botox injections because I thought it would make me look weird. But Dr. Alex and his wonderful staff explained that it is a purified protein and the results will be natural. And they were right. It looks completely natural, the treatment was painless, and I did not even get a bruise. If you want great results and outstanding service I highly recommend A E Skin.

    — Rod Fani

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Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.



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