Category Archives: Spa

Double Points for Allergan Through End of August

Allergan and Salmon Creek Plastic Surgery are extremely excited to announce that between July 14th to August 28th, all patients receiving any type of treatment for an Allergan product (Botox Cosmetic, Juvederm XC, Voluma XC, Latisse, or SkinMedica) will receive double the points.  This double point program will last from July 14th to August 28th.

Cosmetic Procedures Before a Wedding: Get Good Results with Minimal Downtime

Wedding-Party-smOver the last three weeks, I have seen eight patients, each of whom has a son or daughter getting married this summer. All seemed to be handling this role quite well, but each was interested in looking her best for the upcoming festivities. None of the patients wanted anything drastic done or anything that would make them look as though they had actually visited a plastic surgeon. Additionally, none of the patients had any significant downtime availability.

This scenario presents itself quite often at our office, and not just during wedding season. Many people feel they want to look their best for school reunions, holiday parties, and even vacations. Many less intense treatment options now exist which can be very helpful in this exact situation.

Botox: Botox injections can soften stress or frown lines around the eyes and forehead quite effectively. Lines can take a full month to fully diminish after a Botox injection so be sure to plan ahead. We can even use Botox to treat excessive sweating under the arms!

Fillers: Filler injections such as Juvederm or Radiesse restore volume to folds around the mouth and chin, giving a more rested and healthy appearance. Belotero is another clear gel that is used for vertical lip lines (also known as smoker’s lines—even in non-smokers). This is a very superficial injection that lessens the visibility of the lines without looking lumpy.

Laser services: Laser peels and topical skin care products can even out the color and tone of the skin, erasing blotchy sun damage and tightening large skin pores. Laser can also be used for the elimination of spider veins on the face, something which was previously treated with painful injections. And of course, hair removal is the most common laser procedure we do here at the office.

So what did these patients choose to do? Well, I’m not telling, and hopefully the wedding guests won’t figure it out either!

Botox, Dysport or Fillers? It Depends on Your Wrinkles

If you’re looking in the mirror these days and wondering what you can do to smooth out some of those wrinkles, there are a wide array of products and procedures that can help. Knowing which ones are for you starts with getting to know your wrinkles a little bit better.

wrinklesDynamic Wrinkles

Botox and its newer competitor Dysport are made from the botulinum neurotoxin which blocks the action of nerves on muscles and are used to treat dynamic wrinkles, that is wrinkles that are caused by muscle activity.  Dynamic wrinkles are those that are seen when you animate your facial muscles, such as the ’11’ between your eyebrows when you frown, or the lines across your forehead when you try to look up or raise your eyebrows, and the smile lines in the corners of your eyes (crows feet).  These wrinkles can make you look tired and angry even when you are not.

The procedure involved to do a Botox treatment is quite simple. A very tiny needle is used to inject the Botox into the wrinkle-producing muscles. No anesthesia is required and the injections usually take only 10-15 minutes.  There is no recovery time or down time though you may see some temporary redness or bruising at the injection site. On average, it takes 3-5 days to start to see an effect and up to 3 weeks to see the maximum results from Botox.  Results usually last about 3 months.

Static Wrinkles

Fillers are complementary procedures – they are not the same thing as Botox and should not be thought of the same.  While Botox is used to treat dynamic wrinkles, fillers are used for static wrinkles and to enhance volume.  Static wrinkles or lines are those that can be seen even at rest, such as the nasolabial fold that runs from the side of the nose to the corner of the mouth on each side or marionette lines.  Fillers are used to ‘fill’ these static lines and folds.  It is important to note that these static wrinkles have multiple causes: loss of volume of the face as we age, sagging due to gravity, and some static wrinkles are accentuated by muscle activity (e.g., nasolabial folds deepen when smiling).  Fillers can also be used to plump or augment the lips and treat lipstick bleed lines.

Commonly used fillers include collagen (Cosmoderm, Cosmoplast) which is a natural substance known as a protein and is the main component in cartilage, teeth and bones; hyaluronic acid (Belotero, Captique, Perlane, Restylane and Juvederm) which is also a natural substance found in your body, high concentrations are found in soft connective tissue and in the fluid surrounding your eyes as well as in some cartilage and joint fluids, as well as skin tissue; calcium hydroxyl apatite (Radiesse) which is found naturally in human bones, and polylactic acid (Sculptra) which is a synthetic material that when injected, stimulates the body’s own production of collagen.

Filler injections usually require local or topical anesthesia and can take anywhere from 15 to 30 minutes or more depending on the area being filled.  You should stop any NSAIDS (aspirin, motrin, ibuprofen, naprosyn,  alleve, etc) for at least one week before the procedure to minimize bruising and swelling and avoid scheduling any important social events for at least several days after the injections. Fillers are temporary lasting anywhere from 6 months to over a year and need to be repeated to maintain your results.

Where to start

It is not uncommon for us to see patients who have a combination of static and dynamic lines, so often these two types of treatments are used together in facial rejuvenation. Dr. Green and Dr. Huang can examine you for both dynamic and static wrinkles and give you an opinion on which agent to use where. Call us at 360.823.0860 for a free consultation.

The Evolution of the Non-Surgical Consultation

bio-greenWhen I first began practice 17 years ago, I found it very strange that folks would show up at our surgical office with no intention of ever having surgery. They came looking for the magical, noninvasive, miracle treatment with no downtime and no risk. Some days, I enjoyed these visits because the appointments were very short. We had very little to offer other than the Obagi system, a Retin-A based skin care line that has been around for over 25 years (and that we still use with great success). Collagen injections did exist at the time, but the results only lasted about three months, and many people were allergic to the product as it came from cows. I personally never thought the injections were worthwhile.

Then came Botox. We added this to the practice about 12 years ago, and all of a sudden the consultation appointments started to get a little longer. Botox works amazingly well as long as it is injected into the right location, and it is minimally invasive with essentially no downtime and minimal risk. Not exactly a miracle treatment, but close.

This is a photo of Dr. Green from 1996.

This is a photo of Dr. Green from 1996.

11 years ago, I decided that I would like to add laser to the practice. The fact that I had had no previous laser experience didn’t slow me down as I have always enjoyed learning new tricks and techniques. With a willing group of “guinea pigs” among my staff and friends on which to learn, the various laser applications (hair removal, spider vein treatment, wrinkle reduction, etc.) quickly became some of our most popular non-surgical treatment options.

Rapid improvements in injectable fillers soon followed, with longer lasting products that did not provoke any allergic response. The typical fillers of today are composed of materials already found in the body, and so the immune system does not recognize them as foreign. We can also inject them more smoothly, minimizing the appearance of lumpiness. One of the nicest things about fillers is that the results are visible almost immediately, and much longer lasting than the collagen of old.

Now when a patient comes into the surgical office with no intention of ever having surgery, we actually have a lot to talk about. The appointments last as long as a surgical consultation, and patients have many options to consider. Almost too many sometimes!

Patients often ask me to tell them what they should do. I rarely choose to do that, opting instead to tell them what they could do rather than what they should. Twenty-three years of marriage has taught me that is the better strategy!