Experience Laser Skin Rejuvenation at JUVA
At JUVA Skin and Laser Center, we are proud to be on the cutting edge of laser technology. Our center is unique in offering a multitude of lasers to treat a variety of skin problems as well as sun-damaged skin. At JUVA we have lasers used for skin resurfacing that are non-ablative(which do not remove the epidermis, or the top layer of skin) as well as the traditional ablative(which remove the epidermis) lasers. The non-ablative lasers work on the deeper (sub-surface) skin layers to aid the growth and replenishment of collagen production. The ablative lasers yield a more remarkable improvement in the reduction of wrinkles and in skin tightening but require more downtime.
Our non-ablative lasers include the Affirm Laser and the Titan Laser. The Affirm Laser is the newest fractional non-ablative resurfacing technology to remove wrinkles, improve skin and texture, and pigmentation. It reduces wrinkles, treats scars (including acne scars) and improves overall skin texture as well as tightens the skin. It has a wavelength of 1440 nm. Unlike other lasers, this new innovative laser has a new headpiece with a grid that allows part of the skin to be treated like an ablative resurfacing laser. With this new technology, you can get the benefits of a resurfacing laser without the downtime that is associated with it. Additionally, the Affirm Multiplexä laser is a non-ablative fractional laser that utilizes a unique delivery system of firing two different wavelengths through the same laser fiber sequentially. The 1440nm targets the epidermis and the superficial dermis and the 1320nm targets collagen in the deep dermis. The Affirm’s specialized Multiplexä technology redistributes the laser energy into varied levels of heat intensity thus fractionating the laser energy. The treatment is fast – taking only about 15 minutes for the whole face. Treatments with the Affirm are performed using an air cooling system that increases patient comfort. Typically 4-6 treatments spaced 2 to 3 weeks apart are required for optimal results, but you will see noticeable results even after the first treatment. After treatment, your skin will have some redness and swelling for a few hours that can be covered with make-up.
The Titan laser is an 1100 to 1800 nm infrared light laser that uniformly heats the collagen beneath the skin to produce tightening effect. It is a non-ablative laser technology used to treat lax skin on the body including the jawline, chin, neck, and abdomen. There is no downtime and 4-6 treatments spaced 2 weeks apart are required to achieve the desired result.
Our ablative lasers include the Sciton Profractional, Sciton Erbium Micropeel, Erbium:YAG, and Ultrapulse CO2 lasers. The Sciton Profractional laser utilizes a 2940 nm Erbium:YAG to deliver energy deep into the dermis ablating micro-channels of tissue and stimulating rejuvenation of the collagen matrix. The laser has great versatility. It can selectively treat, in a single pass, from 1.5% to 60% of the skin area and up to 1500 microns in depth of the epidermis and dermis. All skin types can be treated without the risk of increased pigmentation. Treatment can be adjusted to the patient’s specific skin condition and available downtime.
The Sciton Profile Erbium Micropeel laser is a 2940 nm Erbium:YAG laser that vaporizes (ablates) the skin. The physician precisely controls the depth of the laser beam penetrating into the dermis, tailoring the treatment to the specific needs of each patient. The Sciton Profile can erase fine lines and wrinkles, smooth and tighten eyelid skin, soften smokers’ lines, remove brown spots, and improve uneven skin color. Acne scars as well as traumatic scars can be improved quite dramatically.
The Erbium:YAG laser is a 2940 nm infrared light laser which targets water in the skin. It is the newest and most precise, superficial ablative skin resurfacing laser to remove wrinkles, sunspots, sun damage and acne scars. Recovery time is rapid and redness clears faster than with previous lasers used for these purposes.
The Ultrapulse CO2 laser is a 10,600 nm infrared light laser which targets water in the skin. This laser is used for ablative skin resurfacing to remove wrinkles, sunspots, sun damage and acne, traumatic and surgical scars. It produces tightening of the skin by causing collagen shrinkage. We invite you to explore the options JUVA offers in laser facial rejuvenation, wrinkle reduction and tightening of the skin on your face, neck and chest. To see if which laser treatment is right for you, call Juva 212-688-5882 to schedule a consultation.
Cheek Enhancement: The Next Frontier
During professional and social interactions we all make judgments about the health, vitality, and beauty of those we meet. When observing a face, the most obvious hallmark of youth is full cheeks (malar eminences). A youthful face is characterized by a balanced distribution of superficial and deep fat, which result in a three dimensional series of arcs and convexities, supported by the underlying body skeleton. In a youthful face, the transition from the cheek to the lower eyelid is a subtle lid-cheek interface which is barely distinguishable. It is where the cheek ends and the eyelid begins. Likewise, the transition from the cheek to the facial tissue below (submalar area) is an equally subtle transition.
With aging however, all this changes. The soft tissues of the mid face descend, the lid-cheek interface becomes more apparent with the appearance of a longer, lower eyelid that is punctuated by a prominent depression, the tear trough. Additionally, puffiness of the lower eyelid, prominence of the bony orbit, loss of cheek prominence, a hollow submalar area below the cheek bone and the development of prominent laugh lines (nasolabial fold-lines that run from the mouth to the nose) collectively contribute to a tired appearance. These changes are accentuated by loss of skin elasticity and bone in the underlying facial skeleton. It is primarily the loss of facial fullness and redistribution of facial fat that provides visual clues to a person’s advancing age.
Fortunately, there is a myriad of options that can enhance cheeks and restore the malar area to a youthful appearance. There are several non-surgical procedures that are less invasive and less expensive, (but not permanent) as alternatives to surgery. The primary goal of facial rejuvenation is to restore the face to a healthy, vibrant, youthful and energized appearance. This can be achieved with a variety of “fillers”, as well as the transfer of fat, which is harvested from any body area with a little fat to spare. Fat transfer, is a well- established, safe, and natural way to restore youthful facial contours. This technique is advantageous, because most patients have an abundance of this natural resource! Using the patient’s own tissue eliminates the possibility of an adverse reaction. Though the fat deposits gradually dissipate, retained portions may last for many years. Fat is an excellent choice for enhancement of the cheeks, softening of the lid-cheek interface, or the correction of facial hollows or concavities. The procedure is usually performed under local anesthesia and patients usually return to work within a week.
Synthetic fillers can also be used to rejuvenate the malar, submalar area and lower eyelid-cheek interface. Synthetic fillers include Restylane, Perlane, Juvederm, Radiesse , Sculptra, and Evolence. Depending on the filler, and the area treated, the results can last up to 2 years. As opposed to fat, “fillers” have a greater ease of application, require no recovery and give an immediate instantaneous result.
To decide whether you are a candidate for facial rejuvenation with fat or fillers, schedule a consultation with Dr. Katz or Dr. Bruck.
Baggy Eyelids – Too Much Fat, or Not Enough in the Right Place?
We don’t have to tell you: as a natural part of the aging process, facial contours change. What was once a youthful, energized appearance somehow turns into a tired, sunken appearance. Changes that first appear in the early 40’s become progressively worse. Facial tissues descent and fat atrophies, causing a lengthened lower eyelid and a distinct junction between the eyelid and cheek. That hollow beneath the eyelid is known as a “tear trough” deformity. What it might seem that the solution is to remove fat from those baggy eyelids, the better option may be quite the opposite—adding fat to recontour the facial architecture by enhancing the cheeks to minimize the tear trough. This can be achieved by transferring fat to this area, which restores a rested, healthy and energized appearance.
When isolated to the eyelid cheek junction, the procedure often can be performed under local anesthesia. A nerve block is administered where the fat will be placed. Fat can be harvested under local anesthesia from almost any body area that has a little extra, and is then centrifuged, separating out fat cells. Through an incision no larger than a pencil tip, several layers of tiny parcels of fat are carefully injected into sunken areas, artistically reestablishing youthful facial contours. Postop, there is usually moderate bruising and swelling, most of which clears within a week; any residual bruising can then be concealing with cover-up, and most patients can return to work.
Dr. Bruck has a wealth of experience with fat transfer and would enjoy discussing whether this is the right procedure for you.
Breast Lift, or Breast Augmentation Which Will Work Best For You?
There are many women who come to the office requesting breast enlargement who may not be candidates because their breasts are drooping. Drooping or ptosis of breast tissue actually can occur early in some women at puberty or late teens, as well as after pregnancy, or later in life with menopause. Breasts lose their upper pole fullness as breast tissue drops, the nipple areola complex descends, and there may be a change in breast shape. In some instances a breast implant may be all that is necessary to improve the appearance of a drooping or ptotic breast. It can fill lax skin, give better contour to the breast and keep scars to a minimum. However, in other instances a breast lift or mastopexy with or without an implant may be necessary to improve the shape and position of the breast tissue and nipple areola complex.
For some women whose breasts may be small due to changes following pregnancy, weight loss or due to lack of development but are not ptotic or for women with moderate size breasts who desire cosmetic enhancement, an implant is usually the ideal solution.
Breast augmentation is one of the most immediately gratifying procedures for both patient and surgeon. Ideally the enlarged breasts will not only look good, appearing natural, and symmetric with soft curves and flowing lines but they will also feel good, feeling soft, warm and sensitive to touch.
In deciding whether a breast augmentation, breast lift, or a combination of both procedures will give the best outcome, the surgeon considers breast volume and shape, skin elasticity, and nipple position. Patients often say that they want a youthful “perky” uplifted breast without visible scars. A mastopexy is designed to return breast shape to a more youthful appearance by moving the position of the nipple-areola complex, removing excess breast skin, and reshaping the breast tissue. In some instances a breast lift is not sufficient to restore a youthful appearing breast as there has been loss of breast volume as with postpartum breast involution (shrinking of the breast after pregnancy) Combining breast lift with a breast augmentation improves breast shape, enhances breast volume and may reduce scarring. Depending on the degree of lifting necessary, one of three types of breast lifts can be performed each resulting in different degrees of scarring. When the nipple-areola is low and needs a small degree of elevation, a crescent-shaped ellipse of skin can be removed to elevated it “hiding” the scar at the border of the areola. When breast skin is loose and the nipple-areola complex also needs to be elevated a ring of skin is removed around the nipple-areola complex. This technique works best when used in combination with a breast augmentation. For moderate to large degree of ptosis, the circumareolar skin excision with a vertical elipse of skin removed below the areola the so-called “lollipop” lift can be used. When larger amounts of skin need to be removed a horizontal ellipse of skin is removed producing an anchor-type scar. The combined procedures of breast lift and breast augmentation are a surgically challenging operation and many surgeons prefer to stage the procedure first performing the lift followed several months later with insertion of an implant.
Dr. Bruck performs breast augmentation, breast lift, or the combination of lift and augmentation at Juva, a certified outpatient facility, as well as in the hospital outpatient surgical suite. Patients usually return to work within a week after surgery.
Botox®: A Solution for Excessive Underarm, Hand, Feet and Forehead Sweating
The most common form of hyperhidrosis is focal, or limited to the palms of the hands, soles of the feet, the underarms, or the face. It is estimated that 5.8 million Americans have problems related to focal hyperhidrosis. Do you suffer from underarm sweating so severe that it stains your clothing and makes you feel uncomfortable in certain social settings? Did you know that there is an answer to this problem?
Botox® is FDA-approved for severe underarm sweating when topical agents are not effective and is covered by many insurance plans for this purpose. Botox® temporarily blocks the chemical signals from the nerves that stimulate the sweat glands in the treated area and helps to control severe primary axillary hyperhidrosis, or severe underarm sweating.
In a clinical study of 322 patients evaluating the efficacy of Botox® treatment of severe underarm sweating, 55% of Botox® treated patients achieved an effective reponse compared to 6% of patients treated without Botox®. In addition, 81% of Botox® treated patients had a greater than fifty percent reduction in sweating compared to 41% treated without Botox®.
The treatment is straightforward and involves multiple injections with a fine needle of Botox® solution into the affected underarm area. A topical anesthetic cream is applied to the area prior to treatment for patient comfort. Results are noticed within a few days to four weeks of your first treatment. Botox® treatment is safe and is not a cure. The effects will gradually wear off and underarm sweating will resume. On average, a Botox® treatment for severe underarm sweating lasts six months, but you will know when you are due for another treatment as your symptoms return.
Sweaty hands and feet are often very embarrassing for patients and can increase anxiety and stress in both work and social situations. Botox® treatment can also successfully treat severe hand(palmar) and feet(plantar) sweating as well as sweating of the face.
If you feel you are a candidate for Botox® treatment for severe underarm, hand, feet or forehead sweating, please call the Juva Skin & Laser Center at 212-688-5882 to schedule an appointment.
