By 2g1c2 girls 1 cup

New Posts Coming Soon!

Hi Everybody!

Dr212Renew here just letting you know that I am back after a goofy technical vacation (blog trouble)!  I have many new things to tell you so make sure that your RSS feeds are still up and active!

Talk to you real soon!

Dr. Lisa

 

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“Vampire Facelift”- Dr Zdinak featured Expert in New York Times!

new-york-times

‘Vampire Face-Lifts’: Smooth at First Bite

By CATHERINE SAINT LOUIS

IN this anti-aging age, perhaps it’s unsurprising that vampires — ancient, but with forever-young skin — are a cultural obsession. Now a cosmetic treatment to fill in wrinkles or to plump up hollow cheeks is being marketed as a “vampire filler” or a “vampire face-lift.”

In fact, it’s not surgery, but an in-office procedure that entails having blood drawn from your arm, then spun in a centrifuge to separate out the platelets. They are then injected into your face, with the hope of stimulating new collagen production. Selphyl, as the system is called, arrived on the booming facial-rejuvenation market in 2009, and is now used by roughly 300 doctors nationwide in the name of beauty, said Sanjay Batra, the chief executive of Aesthetic Factors, which manufactures the Selphyl system.

This year, the “vampire face-lift” has been promoted on “The Rachael Ray Show” and “The Doctors.” It’s also gotten air time on more than a dozen local news programs, some of which presented unproved claims that results will last two years.

Dr. Drew Ordon, one of the hosts of “The Doctors” and a board-certified plastic surgeon, gushed on air, “Vampires have moved into plastic surgery, too, and I’m one of them.” The patient in his segment had also recently had her own fat injected into her face to plump it, so it wasn’t clear that platelets had anything to do with her fresher appearance. (Not that that stopped audience applause.)

Ghoulish as the procedure sounds, some patients prefer the idea of using their own blood rather than a neurotoxin or synthetic filler to rejuvenate their faces. “We all want to look better,” said Joan Sarlo, 56, who underwent a Selphyl “vamp-lift” performed by Dr. Lisa A. Zdinak, a Manhattan-based doctor whose specialty is ophthalmic plastic surgery. But the “less unnatural the better,” Ms. Sarlo said. “What could be better than your own blood?”

Some doctors say that fillers taken from one’s body are less likely to cause irregularities and bumps in thin-skinned areas than synthetic ones like Sculptra Aesthetic. But at this point, it’s hard to tell whether “platelet-rich fibrin matrix,” or P.R.F.M. (the medical term for the golden-hued platelets that Selphyl extracts), is an effective filler for hollowed-out cheeks and wrinkles.

Dr. Anthony P. Sclafani, the director of facial plastic surgery at the New York Eye and Ear Infirmary, said he’s seen the revivifying effects of P.R.F.M. on cosmetic patients last for more than a year — sometimes 18 to 24 months. (Dr. Sclafani is a paid consultant for Aesthetic Factors, and most of his research on Selphyl has been financed by the company.)

But no national clinical trial has been done to prove such claims. “There simply isn’t any objective data out there supporting the claim of two years,” Dr. Jeffrey M. Kenkel, a board-certified plastic surgeon and a spokesman for Physicians Coalition for Injectable Safety, wrote in an e-mail.

Dr. Phil Haeck, the president of the American Society of Plastic Surgeons, is troubled by the lack of research proving the efficacy of Selphyl, which costs $900 to $1,500 for a procedure that takes less than a half-hour. “There are no scientific studies, only personal attestations,” he said, adding that he thinks the “creepy” concept is as antiquated as bloodletting to cure disease. “This is another gimmick that people are using to make themselves stand out on the Internet in a real dog-eat-dog part of medicine.”

What’s more, doctors and consumers aren’t clear on where Selphyl stands with the F.D.A. In a YouTube video featuring Dr. John Argerson, a board-certified family medicine doctor who works out of Refine MediSpa in Johnson City, Tenn., tells consumers that Selphyl is a “newly F.D.A.-approved filler” for nose-to-lip folds. And in a December 2009 article in Dermatology Times, a trade publication, Dr. Ranella Hirsch, a board-certified dermatologist, said Selphyl is “a new F.D.A. approved dermal filler.” This week, Dr. Hirsch, who doesn’t use Selphyl in her practice, said that she couldn’t explain why she misspoke, adding in an e-mail that “the lack of clarity between F.D.A. approval versus F.D.A. clearance to market is a key point.”

Indeed. The F.D.A. has not approved or cleared P.R.F.M. derived in a Selphyl centrifuge to be marketed for facial rejuvenation. In 2002, the agency cleared a blood-collection system called Fibrinet, whose platelet-rich byproducts orthopedic doctors then used to speed tissue repair. In 2009, this same machine was born again as Selphyl, and since then, the company promoted it as a way to “reverse the natural aging process.” This week, Shelly Burgess, an F.D.A. spokeswoman, said that Selphyl’s maker would have to file an amendment to get clearance to market its blood collection system in a new way, and no such amendment could be found at this writing.

Asked whether Aesthetic Factors’ marketing of Selphyl for cosmetic rejuvenation violated any F.D.A. policy, Ms. Burgess simply wrote, “As a regulatory agency we would not discuss whether a firm’s claims violate our regulations.”

Dr. Anthony Youn, a board-certified plastic surgeon who introduced the vampire face-lift to viewers of “Rachael Ray” this year, admitted in an interview, “There’s very little data behind Selphyl” and that he’s injected just a half dozen patients with P.R.F.M. “Patients tolerate it beautifully, but I haven’t seen any dramatic results yet,” said Dr. Youn, based in Troy, Mich.

Dr. Sclafani, who has injected roughly 150 patients, wrote in an e-mail that Selphyl can correct early signs of aging like crow’s feet, loss of facial volume and under-eye hollows “in a progressive, natural way and rejuvenate a person’s appearance in a subtle but distinct way.”

Dr. Joseph M. Gryskiewicz, the chairman of the emerging trends committee for the American Society of Plastic Surgeons, said he was impressed by Dr. Sclafani’s before and after photos, some taken with appropriate lag time to test longevity. “They look as good as any filler out there,” he wrote in an e-mail. Dr. Gryskiewicz, a board-certified plastic surgeon in Edina, Minn., who doesn’t offer the “vampire filler,” doesn’t feel P.R.F.M. derived from Selphyl can be compared with Botox, because, he wrote, “one fills a space, the other inhibits muscle action.” But he sees the point of using Selphyl’s P.R.F.M. as a volumizer, considering the alternatives. “Lots of patients are freaked out about the lumps with Sculptra, and lots of patients don’t want to do surgery that is fat transfer, but they want their hollow cheeks fixed.”

Last week, a retrospective no-placebo study of 50 of Dr. Sclafani’s patients injected with their own platelet-rich fibrin matrix one to five times and then assessed on average 9.9 months later was published online in the Archives of Facial Plastic Surgery. It didn’t prove that P.R.F.M. is an effective filler, but Dr. Kenneth R. Beer, a dermatologist in West Palm Beach, Fla., said it did suggest that it was generally safe to use to treat nasiolabial folds or sunken cheeks. That said, Dr. Beer, who is a paid consultant and investigator for Medicis and Allergan, the makers of Restylane and Juvéderm respectively, wrote of Selphyl in an e-mail: “The major risk, in my estimation, will be from people that don’t understand the anatomy or the procedure injecting this into veins or arteries.”

Since last March, Dr. Ali Vafa, a board-certified internist who now injects fillers at New York Medical Aesthetics in SoHo, has offered Selphyl to patients afraid to use Botox or synthetic injectables — thus far about 35, some in conjunction with other fillers. But there isn’t a lot of “good clinical research behind” the procedure, he said. “You sort of go by what other doctors have seen who have been doing it for a period of time.”

Ann, a 39-year-old preschool teacher from Brooklyn who wanted to use only her first name for privacy’s sake, had her hollow cheeks treated by Dr. Vafa last August. “As part of the aging process, all our faces will thin out,” Ann said. She saw a gradual improvement after Selphyl, and liked that she didn’t have any palpable bumps as she had after using Perlane, a hyaluronic acid filler approved by the F.D.A.

“When they come to me, I don’t promise it will improve everything,” said Dr. Vafa, who charges $1,000 to $1,200 to inject P.R.F.M. “I say it’s for prevention, it will improve skin quality and volume.” He calls the procedure a “vampire face-lift” on one of his Web sites, though with some squeamishness about its sensationalism..

But Dr. Charles Runels, a cosmetic doctor in Fairhope, Ala., liked the term so much he trademarked it. Dr. Runels, who used to be a board-certified internist, said this was to standardize the offering so patients know what to expect. His vampire face-lift entails first volumizing the face with Juvéderm, a hyaluronic acid filler that lasts up to a year, then “using Selphyl to polish off under the eyes, and thinner-skin areas,” he said.

Now any doctors who want to promote the vampire face-lift must pay Dr. Runels $47 a month to follow his protocol, posted online. (So far, 10 have signed up.) Asked what he intends to do about all the doctors already using vampire face-lifts, he said, “I don’t know how I’m going to rein it back in but I will.” Maybe Dracula could help.

Stay Beautiful!!

Dr. Lisa

 

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We’re finally moving to the Upper West Side– December 8, 2010!!

I can believe anything provided it is incredible--Oscar Wilde
I can believe anything provided it is incredible--Oscar Wilde

 

 

 

 

 

 

Dear Friends and Valued Clients,

 

I am so excited to be telling you that we are finally moving our offices to the new Central Park West facility effective this Wednesday, December 8, 2010.  Our new office location will be 10 West 74th Street, Suite 1A, New York, NY 10023.  [74th and Central Park West].  Our telephone number remains the same at 212-799-1411.

We have been looking at this valued office building for the past three years and finally the ideal space became available right across the hall from our friend and long-time colleague, celebrity nutritionist Oz Garcia.

We caught the space in raw construction, and after carefully listening to your feedback and directly involving some of our clients for their expertise, we have created what I hope will be the dream facility for you to receive your services because we designed everything with your experience as a patient in mind.

The space begins with an elegant showpiece opening and a sophisticated yet classical waiting room.  At this point, you will be offered your choice of hot or cold beverage before being escorted to what I like to call “the inner sanctum.”  None of the treatment rooms are visible from the waiting room, ensuring your complete and total privacy during your time spent with us.  Each room is fully equipped with a personal sink and mirror so that makeup can be removed and applied inside of the treatment room before and after your procedure.  The walls are sound proof to preserve privacy and serenity, and the climate of each room is controlled individually by its own thermostat for your ideal temperature setting.  All of the treatment tables are brand new, fully reclinable, and deeply cushioned with every accessory to ensure your complete comfort during long and short stays with us at our facility.  Volume controls for the speakers are also located in every room so that you can relax in complete silence, or enjoy what the rest of the staff is listening to while we work.  Alternatively, we are fitting each room with an iPod docking station so that you can listen to your own music if you prefer!

I will be sending you an official letter formally announcing our move, but in the meantime, I wanted to tell you about all of the fabulous improvements that we have made for you, not discounting the fact that you can literally cross the street and be in Central Park!

p.s. Many new procedures are in store for you for the holidays, as well as some planned specials to celebrate our move and to welcome you into our new home.

 

Stay Beautiful!

 

Dr. Lisa

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I’m Somebody!!! Now, all I need is this chair, and this book…

 

individual-peacock

Hello my pretties!

 

I am so sorry that I haven’t written to you in awhile, but trust me, I have been VERY busy working on several projects to bring you even more technologies from abroad.  I can’t decide, should the next one be from Japan, or Austria?  Would you rather painlessly melt areas of unwanted fat and cellulite from your body, or have the most perfect serum to keep your skin flawless like the Russians?  Oh, what the heck, let’s do both!!

 

On another serious note [yes, the above was serious, I AM bringing these two items to you soon], I have been blessed and honored to have been recognized by my own industry three times this month:

 

(1)  I am currently featured in the September/October 2010 issue of MedEsthetics magazine alongside industry leader Andrew P. Ordon, MD from the television show "The Doctors."  MedEsthetics magazine is a peer-related journal where doctors teach other physicians how to safely and effectively perform cosmetic procedures.  You can read the entire article at my website by going to www.lisazmd.com.  I discuss safely treating areas off-face using a variety of techniques.

 

(2)   I am very excited to have been included in the 2011 edition of Marquis Who’s Who in America!  Marquis Whos’ Who has been recognizing men and women from around the world whose achievements influence the people of today and preserves their biographical information for the public record and for posterity.

(3)  I am also featured not once, but twice in the September/October 2010 issue of The Aesthetic Guide, a peer-related journal that is devoted to keeping other physicians up-to-date about the newest aesthetic technologies and helps doctors to chose the proper devices for themselves and for their patients. In this edition of TAG I am on the panel of experts discussing the latest in skin tightening technologies. I am currently working on getting the .pdf of the magazine so that you can see for yourselves! 

But, enough about me.  Stay tuned for a very, very exciting announcement for you to be made before the end of this year…

Stay Beautiful!

Dr. Lisa

p.s. I discovered this awesome shade of Essie nail polish called “Merino Cool.”  It’s from the new fall line, and it’s a beautiful shade of soft, neutral purple polish that can actually be worn by professional women who so often feel left out of the fun color crazes for their fingertips (Chanel “Jade”) because people would be a little worried about their plastic surgeon coming in with green fingernails.  I’m serious, this shade is so subtle yet serious, and I totally love it!!

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TO THE BRAVE MEN AND WOMEN IN OUR MILITARY

memorial-day2

Thank you all, brave men and women in the military, past and present, for your service to this country.  My thoughts and prayers go out to you daily and to your families who have the toughest job of all.  Having lived in D.C. and operated at Walter Reed Army Hospital, I have had the distinguished honor of having met you and at times, taking care of you.  My thoughts and prayers go out daily to our brave troops, and especially on this weekend, to the families and troops who have paid the ultimate price for their country to ensure that freedom rings.   No words can express our eternal gratitude, you will never be forgotten.

 

Stay Free,

Dr. Lisa

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FORGET FRAXEL, THE DERMAROLLER IS HERE!!

Pickin' up my needle and movin' to a different groove!

Pickin' up my needle and movin' to a different groove!

Since I am always scouring the world for you to bring back the best technologies…”oops, I did it again!”  It makes me happy to bring you, all the way from Germany, the Genuine DermarollerTM (yup, first in New York City).  The Genuine DermarollerTM is a microneedling device that is about the size of a toothbrush and looks like a paint-roller covered with micro-fine needles to be gently rolled on the skin surface. 

Why in the world would anyone want to roll needles over their skin?  Seems a bit masochistic… but, it works!  Microneedling has its origins in acupuncuture and has gained medical attention over the past two decades as a method to use at home for allowing product penetration deeper into the skin surface. 

The home-use cosmetic DermarollerTM  has 192 micro-fine needles that are 0.15 mm in length, just the perfect length to exfoliate the superficial epidermis.  Since the nerves are located well below this level, the Dermarolling doesn’t hurt, it just tickles!

Medical Dermarolling is a medical procedure performed on an outpatient basis by a licensed physician as a method for promoting collagen formation that surpasses lasers both in effectiveness and safety. 

CELEBRITY ENDORSEMENTS FOR MICRONEEDLING AND A WORD OF CAUTION

The technique of microneedling has been featured on the “Rachel Ray” show, and the television show “The Doctors” and has been endorsed by such famous persons as Angelina Jolie and Brad Pitt.  Please be careful from whom you purchase a “Dermaroller” because there are many, many unsafe imitations on the market that are available for purchase over the internet that are substandard copies of the Genuine DermarollerTM.   The Genuine DermarollerTM series are manufactured in Germany and have extremely hard, solid (non-hollow) ice-hardened Swedish stainless-steel needles, cylindrical in shape, with a very small tip radius and a thick 35 micron base radius.  The microneedle fracture force is hundreds of times greater than the skin insertion force, giving the device an absolute margin of safety.  What this means in simple terms is that no matter how hard you press with the cosmetic home use Genuine DermarollerTM  the needles will not bend or break.  The Genuine DermarollerTM is an FDA approved medical device that can only be purchased through a physician.  Other “dermarollers” that can be bought over the internet have softer needles of lesser construction that can break, or bend into the skin forming a “fish hook” that can rip the skin surface to shreds.  The whole idea of microneedling the skin is to make you look younger and fresher, not like Freddy Krueger, so please, only buy your Genuine DermarollerTM from me.  I am the only physician carrying the Genuine DermarollerTM in New York City!

 

 

HOW THE HOME USE COSMETIC GENUINE DERMAROLLERTM WORKS

This simple little device is such a powerful tool on the molecular level that its brilliance is inconceivable, but I will try to explain it.  As you know, the skin is structured like a layer-cake.  The uppermost layer is the epidermis, and this is where the pigment cells reside, so the epidermis is what gets sunburned and freckled.  Beneath the epidermal layer lies the dermal layer of the skin that contains the structural protein collagen that gives skin its strength, and elastin which gives skin its stretch.  The loss of collagen and elastin as we get older is what causes wrinkles and sagging skin [“oh horrible, horrible, most horrible”]! Beneath the dermal layer we find the sensory nerves, fat cells, and blood vessels that provide the skin nutrients.  

The epidermal layer is the most superficial layer, and it is broken down into 5 layers [not important], let’s just say that the most important layer is the stratum corneum, it consists of compressed mature skin cells that have grown from younger “basal cells” that reside in the deepest layer of the epidermis and they are the actively dividing stem cells that give birth to new skin cells that must push their way up to the skin surface and emerge as mature skin cells [similar to the game “King of the Hill”].  These mature skin cells form a protective skin armor to keep moisture in while keeping other things out [like bacteria, or your favourite expensive moisturiser]!  As we get older (past the age of 28 years) our skin makes 1% less collagen per year, while the enzyme that degrades collagen (collagenase) increases.  Thus, production goes down, destruction goes up, and wrinkles form.  Our skin also doesn’t exfoliate as well so the fresh, new skin cells that want to emerge from the deeper layers of the skin cannot push off the crusty cells on the surface, giving the skin a dull, grey appearance.

Basically, the Genuine DermarollerTM has multiple mechanisms of action, all of them good.  The DermarollerTM will work with our without the addition of a cosmetic cream.

--The fine needles of the DermarollerTM, since they are a metal, have their own natural electrical charge.  The skin cells also have their own natural charge.  When the DermarollerTM is rolled across the skin, the epithelial stimulation causes the nerve cells to send signals to the surrounding skin cells that then sets off a cascade of molecular reactions that leads to the release of growth factors that stimulates stem cells to proliferate and the newly produced fibroblasts migrate to the area to build more of your body’s own natural collagen.  All this, from a little tickle!

--The more specific benefits and mechanism of action achieved from the DermarollerTM directly correlate to the length of the needles.  The home-use cosmetic DermarollerTM has a tiny needle length of 0.15 mm and is an excellent tool for the enhancement of active substances, improvement in skin texture, and thickening of the epidermis (which thins with old age).  The medical use DermarollerTM has needles ranging from 0.5 mm to 1.5 mm in length and is used in the medical office by licensed physicians to treat pigmentary problems such as melasma and post-inflammatory hyperpigmentation (dark spots from acne scars), administering mesotherapy products, and to initiate Collagen Induction Therapy (CIT) that surpasses the results of fractionated laser resurfacing (FRAXEL) with only one or two treatments and less downtime.  There is even a DermastampTM that has been shown to improve the appearance of chickenpox scars by up to 70% after one use!  Finally, the Beauty Mouse Body DermarollerTM is a cute, little home use device designed to allow for increased absorption of your favourite body treatment creams!

HOME USE GENUINE DERMAROLLERTM and BEAUTY MOUSE BODY DERMAROLLERTM

Home use Cosmetic DermarollerTM Indications:  Anti-aging (increasing epidermal regeneration), increasing product absorption, shrinking pore size and decreasing overactive oil production, hormonal acne that does not respond to prescription drugs.

The home-use DermarollerTM has a tiny needle length of 0.15 mm and is an excellent tool for the enhancement of active substances, improvement in skin texture, and thickening of the epidermis (which thins with old age).  Although the epidermis is extremely thin, about 10 to 20 microns thick, even moisturizers with the tiniest of liposomes (200 microns or less) cannot penetrate through the stratum corneum to deliver their precious cargo to the deeper layers of the skin where it is needed.  Findings from the University of Marburg clearly show that even moisturizers with the best liposomes cannot penetrate the stratum corneum, with only about a 0.3% success rate (99.7% wasted).  Using the home-use cosmetic DermarollerTM prior to product application forms fine penetration channels that allow for about 200 times more substance to penetrate the skin.  The stratum corneum reacts so fast and flexibly that the small channels created by the needles are closed within a few minutes.  No bleeding, no bruising.  The active substances are delivered to their proper layer in the skin and locked in tight for a good night’s work while you sleep.  You wake up with glowing skin in the morning.  Used alone, the home-use Genuine DermarollerTM has been scientifically proven to increase the epidermal (uppermost layer of the skin) thickness by over 30%.  This is amplified further by the use of appropriate topical peptides after the DermarollingTM session is complete.  Simply use the device three times a week.  You WILL notice a positive change in your skin.  

The Beauty Mouse Body DermarollerTM was invented simply because we couldn’t ignore the body!  The Beauty Mouse is a fun gadget that looks like a computer mouse and has 3 heads of the same needle length as the home use Genuine DermarollerTM and is designed to allow for deeper penetration of your favourite body treatment products.  Indications: cellulite, enhancement of active substances, improvement of skin texture, epidermal thickening.

The genuine DermarollerTM is not available for purchase on the internet, and I am the only physician in New York City with the Genuine DermarollerTM.  Both the Home-Use Genuine DermarollerTM and the Beauty Mouse Body DermarollerTM are available for purchase through my office to established patients. Simply call us at 212-799-1411 and we will ship you your starter kit today!

 

HOW COLLAGEN INDUCTION THERAPY WORKS

Remember when I said that “this simple little device is such a powerful tool on the molecular level that its brilliance is inconceivable, but I will try to explain it.” Well, now that we are moving on to medical DermarollingTM and anti-aging, it is only appropriate to steal a quote from that fabulous movie about an aging Hollywood Starlet-- All About Eve (1950), “fasten your seatbelts, it’s going to be a bumpy ride!”

The main thing to keep in mind as I explain the medical procedure that uses the Genuine DermarollerTM  is that our skin loses the ability to heal without scar once we are born.  If the developing fetus is injured in utero, the skin will heal perfectly normally.  But, once we are born the skin loses this capacity, and when the skin is cut, the body does a slap-dash job of patchwork quilting the collagen back together again.  It’s reasonably effective and the skin is sealed again, but the new collagen is laid down in a “Three Stooges” kind of fashion, not perfect like it was before.  This resultant imperfect collagen structure is known medically as “fibrosis.” This is evidenced by how the skin heals either slightly darker, or slightly lighter than the surrounding skin (post-inflammatory hyperpigmentation or hypopigmentation, “PIH” among friends). 

When the body tries to heal itself from an injury, it goes through the “wound-healing cascade”-- Inflammation, Proliferation, and Tissue Remodeling.  The blood vessels around the injured area secrete a variety of molecular signals that cry “all hands on deck!”  Specialized cells come to the area to clean up the debris, and then the fibroblast cells arrive to spin more collagen in response to the inflammatory signals.  The fibroblasts spin Type I and Type III collagen initially which is converted to mature, Type I collagen over the period of six months and voilá, “a scar is born” [sorry, couldn’t help it, would you believe I just made that up right now]?

We know that skin loses collagen as we age, and that is why we get wrinkles and saggy skin.  As physicians, the scientific process is always diagnosis and cure.  If we know that the skin loses collagen as it ages, and people don’t like that, then the cure is to get the body to make more collagen.  One way to get the body to make more collagen is to trick it into thinking that it has been injured and launching the wound healing cascade.  Controlled heating of the skin is one way to do this, if the skin is heated to 42 degrees Celsius, the heat-shock protein is released from the cells, the wound healing cascade is initiated, and the fibroblasts come to the area to make collagen (they can’t help it, it is a reflex they can’t resist).  So, as cosmetic laser surgeons, we take advantage of this using lasers to exfoliate and heat contract the collagen in the skin at the same time.  It works pretty well, although depending on the type of laser used, there can be significant social downtime, and there is also a risk of the skin healing a different color than normal because of the PIH I mentioned earlier.  This is the reason that not all skin-types can be treated with lasers, and definitely not the neck because it lacks the appropriate number of healing cells to heal normally from a strong laser treatment.

HOW MEDICAL DERMAROLLINGTM DIFFERS FROM LASER TREATMENTS LIKE FRAXEL

I love lasers.  Lasers were a great boon to surgical science because we could cut and cauterize (burn) blood vessels at the same time with the laser beam, which leads to faster healing with less bruising and swelling (edema) after a surgical procedure. Lasers fry shut the blood vessels in the operative field, thus diminishing the bleeding, which can be pesky and you can’t see what you are doing, a real annoyance to surgeons in general.   A laser also causes less damage to surrounding tissue because there is no pressure exerted on these tissues like is necessary when cutting with a scalpel.  Lasers are a surgeon’s best friend.

 Later on, we started to use lasers to resurface the skin in an attempt to erase wrinkles and sunspots and make Park Avenue ladies look younger than their mystified peers.  The original laser was the CO2 laser which adopted a carpet-bombing effect on the skin by burning off every single cell of the protective epidermal layer and tightening the underlying dermal collagen layer.  The recipient was then placed on house arrest in their penthouse until the epidermis regenerated itself.  Pretty harsh, but effective enough at the time. 

Since the downtime of the CO2 full face laser was so socially unacceptable, fractionated lasers were invented that removed every other cell from the skin surface, giving the skin a jump-start on regenerating itself from the spared skin cells and also offering some protective barriers to the environment with a somewhat intact epidermis.

Now, this is important what I am going to tell you next, so pay heed…

Remember what I said about lasers sealing off the blood vessels as they go about their business cutting and resurfacing?  Well, nature has played a cruel joke on us laser surgeons in that, when it comes to forming collagen in the skin for beauty purposes, you need a little blood (just a touch, just a hint).  Here’s why…

HOW THE MEDICAL USE GENUINE DERMAROLLERTM WORKS

Collagen Induction Therapy with the Genuine DermarollerTM causes the formation of new collagen that is in a microscopically normal network, not a muddled fibrotic scar like that laid down in response to laser treatments.  Let me say that again, Genuine DermarollerTM = normal collagen, laser treatments = scar (fibrosis). 

Medical DermarollingTM is performed under sterile conditions and consists of a drum shaped roller stud with 192 fine micro-needles from 0.5 mm to 1.5 mm in length and 0.1 mm in diameter that is rolled over the skin to penetrate the dermis repeatedly about 20 times.  The skin cells react to these micro injuries and stimulation with the release of various growth factors.  These in return stimulate the proliferation of stem cells and results in neo-collagenesis (new collagen formation) and neo-angiogenesis (new blood vessel formation).  New collagen and elastin fibers are integrated into the existing upper dermal layer without any fibrotic traces.  Although numerous needles with a diameter of 0.1 mm penetrate the dermis repeatedly in the same spot (about 15 to 20 times) down to a maximum depth of 1.5 mm, no wounds in the classical sense occur, and traces of fibrotic tissue could not be detected in histological (microscopic) examination.  The tiny micro-bleedings after DermarollingTM originate from the punctured capillaries that are “emptied” and noted as tiny little red spots beneath the skin’s surface.  But the needles do not cause bleeding in the classical sense, and the red spots go away. 

After a DermarollerTM therapy we always observe the same reactions: neo-collagenesis and neo-angiogenesis.  No ablative LASER procedure will stimulate neo-angiogenesis, and that includes fractional lasers (FRAXEL).  The “hot” laser beam “fuses” the capillaries and other tissue, and the stimuli for sprouting of new blood vessels are suppressed.  The laser beam transforms collagen into necrosis that finally transforms into fibrotic (scar) tissue.  These subdermally set fibrotic points become confluent (merge) after several treatments and result in an upholstering effect below wrinkles.  In addition, the laser beam suppresses bleeding by fusing capillaries, and this in turn stops the release of growth factors from blood platelets.  The laser beam also destroys the stem cells as well as other non-differentiated cells and obstructs their potential for proliferation. 

So, you can see how exciting this technology is for me from both a surgical and molecular viewpoint.  To recap, the Medical DermarollingTM works via the following mechanisms:

----The fine needles of the DermarollerTM, since they are a metal, have their own natural electrical charge.  The skin cells also have their own natural charge.  When the DermarollerTM is rolled across the skin, the epithelial stimulation causes the nerve cells to send signals to the surrounding skin cells that then set off a cascade of molecular reactions that leads to the release of cell signals that that stimulates stem cells to proliferate.

 --the drum shaped roller stud with the fine micro-needles is rolled over the skin to penetrate the dermis repeatedly about 20 times.  The skin cells react to these micro injuries and stimulation with the release of various growth factors, resulting in neo-collagenesis.

-- The tiny micro-bleedings from the punctured capillaries that are “emptied” release growth factors from blood platelets resulting in neo-angiogenesis. 

After a DermarollerTM therapy we always observe the same reactions: neo-collagenesis and neo-angiogenesis.  New collagen and elastin fibers are integrated into the existing upper dermal layer without any fibrotic (scar) formation!  No ablative procedure will stimulate neo-angiogenesis, and that includes fractional lasers (FRAXEL). 

 

MEDICAL DERMAROLLERTM INDICATIONS AND PROCEDURE

Indications:  melasma, hypopigmentation, hyperpigmentation, skin resurfacing, sun damaged skin, wrinkles, large pores, scars, stretch marks, deep wrinkles, deep acne scarring, chicken pox scars (DermastampTM).

 

All medical DermarollerTM procedures are carried out under sterile conditions in the doctor’s office.  A numbing cream is placed on the area to be treated and left in place for approximately 45 minutes to one hour.  Additional medications may be administered depending upon the sensitivity of the particular area and the depth of needle to be used.  Even the deepest procedure is usually tolerable with just some pain pills with or without a valium.

The numbing cream is removed and the skin is cleansed with povidine iodine for sterility.  The skin surface is then rolled in several directions until little red spots appear beneath the skin surface.  The skin is then cleansed with sterile saline and the patient recovers in a comfortable chair with fluffy pillows for about 30 minutes until the micro-channels have closed.  They then leave the office looking as if there is mild sunburn.  This sunburn effect will last about four days.  Usually, by the second day the skin is smooth and the patient can use make-up.  There is no permanent injury to the dermis and there is no sun-sensitivity.  All patients are able to return to work after one week.  The treatment can be repeated without any restrictions, and on any skin type without any risk of pigment changes to the skin. 

In general, 3 treatments are required, 6 weeks apart.  As skin continues to age, it is advisable to go for an annual CIT refresher.  That’s it!

 

Thank-you for taking the time to read all of this complicated information.  It will be worth it to you.  We have been having great success with the Genuine DermarollerTM in my office, and my colleagues from Brasil, France, England, Argentina, and Canada have been having similar success with the device before it hit our shores.  I wouldn’t have written so much if I weren’t as passionate about this technology.  However, I have aged about 10 years trying to compile this for you all, so I am going to go Dermaroll myself right now!  I have a party to go to tomorrow!!

Stay Beautiful!

-Dr. Zdinak

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Posted in Anti-Aging, Fractionated Skin Resurfacing (Fraxel/Pixel), Skin Tightening, Tales of the Wierd (extreme beauty alert)! | Tagged , , , , , | Comments closed

Don’t Forget the Sunscreen!

No, No, No, No, No!!

No, No, No, No, No!!

Well, it’s that time of year again, summer!  That means it’s time for us skin-care professionals and laser surgeons to start nagging you about the sunscreen.  Here is a little primer about the differences between sunscreens and sunblocks.  Remember, a few dollars now on sunblock will save you thousands of dollars on laser treatments in the future!  I may be putting myself out-of-business on this one, but here goes…

SUNSCREENS versus SUNBLOCKS

Sunblocks (physical sunscreens) are opaque formulations which absorb, reflect, and scatter up to 99% of both UV and visible light.  Examples are zinc oxide and titanium oxide.  Sunblock reflects and scatters UVB (B= burning rays) and acts as a wall between your skin and the sun.  (Sunblocks do not protect against UVA rays (A = aging and cancer causing rays).  This may be a better choice if you have sensitive skin since titanium dioxide and zinc oxide are less irritating than Parsol 1789 found in sunscreen.

Sunscreens (chemical sunscreens) absorb specific wavelengths (range of 200-400 nm) and are classified as drugs by the FDA because they are “intended to protect the structure and function of the human integument against actinic damage.”  Examples of chemical sunscreens are Parsol 1789, Octyl Methoxycinnamate, Butyl Methoxydibenzolmethane, and Avobenzone.   It helps protect against UVA rays as well as UVB. 

Mexoryl while sunblock and sunscreen are both great for preventing sunburns, if you really want complete protection from both UVA and UVB look for the newest product on the market called mexoryl.   It has been available in other parts of the world for years, but wasn’t approved by the FDA until recently.  Some sun protection products do contain Oxybenzone, Titanium Dioxide, and Parsol 1789 that block a small amount of UVA rays, but mexoryl is the only product on the market that can actually protect you from most of the UVA rays.  Currently, L’Oreal (La Roche-Posay) holds the U.S.  patent for mexoryl.

Overall, my two favorite sunscreens are either the LaRoche –Posay product containing the Mexoryl, or the Ultraceuticals Tinted SPF 30+ moisturizing sunscreen.  My Ultraceuticals brand flies off of the shelves in my office (last year, we had several cases back-ordered from Australia)!  The Ultraceuticals product contains both Zinc Oxide and Titanium Oxide as physical sunblocks, plus Octyl Methoxycinnamate and Butyl Methoxycinnamate as chemical sunscreens so it provides Broad spectrum protection against UVB, UVAI and UVAII rays.  The product comes in either a light/fair or medium/dark tint, and therefore avoids the “chalkiness” of the usual nose-coat of the sunblocks.  The formulation is light and elegant, and many of my patients love it so much that they stopped wearing makeup and now wear the tinted sunscreen instead because it gives them a great glow PLUS the much needed sun protection without looking chalky.  It is a favorite among my celebrity clientele and Ultraceuticals is a huge sponsor of the Australian Open.  The Williams sisters ask for it by name, and I have introduced it to several celebrity makeup artists who are using it underneath the makeup of both their Hollywood AND their Bollywood stars!  Available at www.lisazmd.com

Stay Beautiful!

-Dr. Lisa

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Posted in Anti-Aging, Dark spots (Age Spots) | Tagged , , , , , | Comments closed

Genetiskin is Here!!

 

Ahh, sweet elixer of youth at last I've found you!!

Ahh, sweet elixer of youth at last I've found you!!

Hello my pretties!!

Well, at long last, Genetiskin is here!!  For those of you who didn’t know, I have been working for several years on developing my own vitamin line specific for the skin.  Why?  Because, those other doctor formulated brands on the market are made of fairy-dust!!  The whole thing started when my patients would ask me, “Hey doc, what vitamins should I take for my skin?” Now, I knew exactly which vitamins to include, but I couldn’t think of any particular brand that I could endorse because since I have many friends and colleagues who are involved in the vitamin industry, I knew that “Brand A” uses only miniscule amounts of the nutrient, “Brand B” uses a form of the nutrient that is not readily absorbed by the body, and “Brand C” is manufactured in a facility where they use shovels to scoop up the vitamins off the floor from a waist high pile like a pooper-scooper (Eeww)!  Enough said,  I had to develop my own line.

And just why, pray-tell you may ask, do I think that I am qualified to design a vitamin line?  Well, I’ll tell you why:  (1) because prior to entering medical school, I was trained as a molecular geneticist who knows how to slice, dice, and julienne fry genes.  True, I was quite good at it.  Made a couple vaccines, grew my own collagen in the laboratory, did massive research on skin-healing and won a couple awards in the process. (2) because of my training as a reconstructive and cosmetic surgeon I know a lot about the skin and what it wants in order to stay healthy.  (3) because my ‘hubbie’ is a nutrition freak and knows everyone on the inside track in the vitamin industry, and (4) because I am a faculty instructor at the World Anti-Aging and Aesthetic Medicine meeting every year  and therefore I am more aware of the hot-new anti-aging therapies used around the world.  This year’s runaway favorite anti-aging supplement was …melatonin.  Kind-of like Windex in “My Big Fat Greek Wedding, or Chris Rock’s ‘Robitussin,’ melatonin is the fix for everything!!

Genetiskin formulas comprise the most bioavailable compounds of nutrients gathered from around the world.  These nutrients are vital to the skin’s overall health and youthfulness.   Precisely engineered and synergistically formulated, Genetiskin supplements boost the stability, absorption, and  potency of nutrients, while speeding support to cells that create the skin’s structural  proteins, fats, oils, peptides, and hormones, all of which diminish over time.  Genetiskin is manufactured in FDA approved facilities and meets the most stringent guidelines of purity and safety.  All Genetiskin capsules are vegetarian based and contain no animal by-products.  All claims are backed by scientific studies and if they didn’t do something for the skin, they weren’t allowed in Genetiskin!  

 Genetiskin-- simply the purest, most potent, proprietary skincare nutrients available in the world!

The supplement line consists of ten key ingredients: 

Collagenesis-patented orthosilicic acid, a form of silica that boosts collagen production by up to 19% within weeks.

Perfect C-a  proprietary extract that has been shown in clinical studies to increase the bioavailability of vitamin C by up to 40%.

 Pure Norwegian Fish Oils- a proprietary blend of ultra-pure Norwegian fish oils contains superior levels of Omega 3 and Omega 6 fatty acids to support the prolonged appearance of smooth, healthy skin.

Resveratrol Ultra- Resveratrol activates a gene called SIRT1 which has been nicknamed “The Fountain of Youth Gene.” SIRT1 increases cellular biogenesis and decreases the oxidative stress that causes the age related deterioration of cells.  Not all resveratrol formulas are equal!  This patent-pending resveratrol complex contains the added power of quercitin and pterostilbene that act as synergistic antioxidants when combined with resveratrol.

Glow Q10- Ubiquinone, or Coenzyme Q10 (CoQ10) is widely recognized as a micronutrient that protects heart health.  CoQ10 may have a wide range of skin protective benefits. Skin aging is generally associated with decreases in tissue CoQ10 levels.  This proprietary, patent- pending, crystal-free CoQ10 offers unparalleled absorption and bioavailability; and clinical trials have shown it to be over eight times more absorbable than other formulas on the market.  

Regenerate-  Alpha-lipoic acid [ALA] has an impressive array of potential benefits for the skin.  Alpha Lipoic Acid prevents glycation- the cross-linking of sugars to the collagen molecule that leads to stiffness, wrinkles, lines, and aging of the skin.   Unlike regular alpha-lipoic acid that has a lifespan of less than one hour in the body, this formulation has a patented controlled-release mechanism that provides day-long protection that “regenerates” other consumable anitoxidants, such as vitamin C, E, and CoQ10.

Damage Control-It is well known that diets rich in cruciferous vegetables, especially broccoli, may reduce the risk of cancer.  In 1992, scientists at the Johns Hopkins University School of Medicine isolated a broccoli seed extract and identified the active ingredient as sulforaphane. Sulforaphane activates glutathione S-transferase that neutralizes the DNA-damaging molecules that are created in the skin by the exposure to sunlight.

D-Mystified- Vitamin D3 is a major contributor in the process of skin cell metabolism and growth.  The bulk of Vitamin D we obtain is formed on the skin via a reaction between the natural fatty acids exuded onto the skin and sunlight.  D-mystified is provided as cholecalciferol, identical to the form in which it is derived in the body from cholesterol and synthesized by sunlight on the skin.

Beauty Sleep-Sleep is a major factor influencing your over-all health and the health of your skin.  Beauty Sleep is an all natural blend of the Chinese herbs formulated to support healthy sleep by balancing hormones related to stress and anxiety. 

Mellow Tones- Called “the Master Hormone,” melatonin releases from the pineal gland, reaching its peak at night to help maintain tissues in a youthful state of health.  The “Melatonin Deficiency Syndrome” is perhaps the basic mechanism through which aging changes can be explained.  By dissolving in the mouth, this formulation of melatonin goes directly to the brain to effectively support night-time sleep.

Genetiskin is a smorgasbord of individual supplements from which you can pick and chose to add to your current regimen.  It is not a multivitamin, but rather simply the purest, most potent, proprietary skincare nutrients available in the world! 

You can learn more and order Genetiskin on-line at www.precisionaestheticsmd.com

Have a Beautiful Day!!

-Dr. Lisa

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Posted in Anti-Aging, Nutrition for the Skin, Skin Care 101 | Tagged , , | Comments closed

Monte Carlo 2010 Anti-Aging Update!

Me wearing the placental mask from Monte Carlo---EEEK!!!

Me wearing the placental mask from Monte Carlo---EEEK!!!

Just flew back from Monte Carlo, and boy are my arms tired!!!  The meeting was terrific as usual, and I have lots of goodies to tell you all about. 

First off, there are two new things that are available right now in my practice; the Exilis Oscillating Wave Body Contouring Device to lose inches of fat without liposuction, and my new skin specific vitamin line “Genetiskin” is finally available after three long years of research and work.  Check out the specifics on the Exilis and Genetiskin on www.lisazmd.com.

Now, back to the meeting in Monte Carlo… as you all know, this was the third year that I have taught at the World Anti-Aging and Aesthetic Medicine conference.  The physician turn-out was good, with over 4,000 attendees from 120 countries. 

Not many new machines were featured this year, although ultrasound is making its way into the marketplace as I predicted [and I already have the exclusive on the best device—the Exilis as I mentioned above].  There is another machine that I was very interested in, but I am keeping it a secret for now, my pretties, until I can get my hands on it for you.  Let’s just say that it does something very unique!

Otherwise, the focus was on the weird this year.  There was one machine that required the operator to wear “ionic gloves” like Michael Jackson and you touch the gloves to the patient’s face, almost like “virtual reality.”   I didn’t see any results with this, although if they put light bulbs on the surface it could beat out glow-sticks in a nightclub any day!

The funniest memory that I will have of the meeting is getting into a virtual “cat-fight” with the Russian physicians clamoring over one small kiosk selling human placental products for the face.  It was worse than a sample sale at Prada, but I did manage to bring back a couple of masks and creams to test on myself to see if they are worth importing for you all.  I tried the mask last night, and it did leave my skin soft and smooth as silk.  It looks pretty freaky while you are wearing it, but there is no smell, and no irritation, so it passed the first test.  I’ll try the lotions for a couple of weeks, and if it’s worth having, I’ll bring enough for the entire class.

That’s it for now.  I have to go and make my traditional slide show for everyone’s enjoyment.

Stay Beautiful!

Dr. Lisa

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Posted in Anti-Aging, Cellulite, DOCTOR TALK- Scientific Journal Update, NonSurgical Body Sculpting | Tagged , | Comments closed

Exilis Body Shaping is the Wave of the Future for Noninvasive Fat Loss!

Shape your body the way you like it with Exilis!

Shape your body the way you like it with Exilis!

 

 

 

 

At last, the long awaited Exilis Body Contouring Machine has been released and is making its New York City debut exclusively at Precision Aesthetics!   The search for a shapelier silhouette continues to drive patients to seek aesthetic therapies, but not everyone is willing to go under the knife to lose inches.  I am thrilled to be the first in NYC to offer Exilis NonSurgical Fat Reduction Therapy, the newest non-surgical method [tranlastion: not liposuction] for body-shaping and circumferential reduction of targeted fatty deposits on the body. 

Exilis is the newest FDA approved technological marvel that offers the unique combination of dual function radiofrequency energy (radiowaves) to the United States marketplace.  What makes this RF so powerful?  Well, it used to be that the only way to remove fat volume from the body (aside from diet and exercise) was liposuction, which requires an incision (scar) and downtime from regular daily activities.  There are several machines on the market that use radiowaves alone, or combined with other forms of energy that can tighten the skin, or treat cellulite, but none can promise actual circumferential reduction until now.  Here’s why:   Fat cells are actually stored in the body in lobules that are clustered like a bunch of grapes.  These clusters are wrapped in a fibrous tissue layer like a hairnet that holds them together.   This fibrous tissue layer makes it virtually impossible to reach the fatty clusters without a liposuction cannula—until now.

The Exilis uses the dual function radiowaves to volumetrically heat the deeper tissues, and then blasts the fat cells with the radiofrequency heat to ramp up their metabolic activity and shrink them.  The patient satisfaction rate is high, with circumferential reductions ranging from 4 cm to 15 cm of volume loss after 4 treatment sessions spaced at 2 week intervals.  All of this occurs in a painless and quick 20 minute office procedure with no downtime or limitations on your activities!

“The Exilis device is literally the ‘wave’ of the future.  I have been following the evolution of this technology for the past year, and I was involved in the original testing of this device.  I treated my thighs and it was a very comfortable experience with a mild, deep-heating sensation.  I awoke the next morning and noticed an improved contour in the ‘saddle-bag’ region that we ladies love to loath.  It was this overnight improvement in such a stubborn area that earned my Exilis its nickname, “the dream machine!”  -- Dr. Zdinak

Stay Beautiful!

Dr. Lisa

 

 

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Posted in Cellulite, Fat reduction, NonSurgical Body Sculpting, Skin Tightening | Tagged , , , , , | Comments closed