Injectables and Fillers
As we age, our skin changes. Over time, the volume of youthful skin begins to diminish as wrinkles and folds form. With injectables and fillers, you don’t have to just sit back and let it happen!
Kybella™ for Fat Reduction Under the Chin
At Fresno and Visalia Dermatology Specialists we help our cosmetic dermatology patients address a variety of aesthetic concerns, including facial wrinkles, acne, unwanted fat, and hair loss. But one area that has had few nonsurgical options for improvement is the chin. Many people are unhappy with excess fat in their chin area—a problem that can make one look heavier and older than they truly are. Fat in the chin is also notoriously difficult to get rid of, and can even affect people who maintain a healthy weight. Until recently, the only effective way to remove fat under the chin (also known as submental fat) was through liposuction, but a new product, Kybella™ offers an exciting non-surgical option.
Dr. Carlos Paz is one of the first physicians in the Central California to be trained and certified in administering Kybella™. Kybella™ is a form of deoxycholic acid, a substance that occurs naturally in the body to aid in breaking down and absorbing fat. The procedure consists of a series of injections into the fat of the chin, which destroys the localized fat cells so that they can no longer store fat. While the number of necessary treatments varies from patient to patient, the result is a slimmer, younger-looking chin with minimal downtime.
BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate to severe frown lines between the eyebrows, forehead wrinkles and crow’s feet for a temporary period. The lines that appear between your brows actually result from muscle movement and the passage of time. During the procedure, Dr. Paz will inject BOTOX directly into the muscle as a simple, nonsurgical treatment. Once injected, Botox works by blocking nerve impulses to the injected muscles, which reduces muscle activity that causes moderate to severe lines to form between the brows.
Juvederm is a smooth consistency gel made of hyaluronic acid, a naturally occurring substance in your skin that helps to add volume and hydration. The smooth consistency gel helps to instantly restore your skin’s volume and smooth away facial wrinkles and folds. During the procedure, Dr. Paz will ease Juvederm injectable gel into the skin using a fine needle to temporarily fill in and augment the treatment area and smooth moderate to severe facial wrinkles and folds. The injection process takes about 15 minutes, the results are immediate and last approximately six months.
Radiesse is a synthetic dermal filler made of calcium hydroxyapatite that helps reconstruct the skin by stimulating collagen production. It is used for soft tissue augmentation and to treat skin folds and wrinkles. During the procedure, Dr. Paz will implant the Radiesse with a small needle.
When injected into the deep dermis and subcutis, Radiesse provides a matrix into which the body’s own tissue can grow and add volume.
Sculptra Aesthetic™ uses a biodegradable injectable filler to correct shallow to deep facial wrinkles and folds. Sculptra works to replace lost collagen in a series of treatments administered by Dr. Paz. Sculptra is a minimally invasive treatment that delivers gradual results to correct facial wrinkles. It provides a refined, more youthful looking appearance that can last more than two years.
Restylane® and Perlane
RESTYLANE® and PERLANE are crystal-clear, non-animal, biodegradable hyaluronic acid gels used for the treatment of wrinkles and lip augmentation. These products can be used to add volume and fullness to the skin to correct moderate to severe facial wrinkles and folds, including the lines from your nose to the corners of your mouth; the area just below the nose and above the upper lip; the corners of the mouth; and marionette lines – the area that extends downward from the corners of the mouth to the jawline. The results from the Restylane and Perlane can be seen immediately.
Belotero Balance ®
Belotero is a dermal filler designed to treat superficial lines and moderate to severe wrinkles on the face. It is very natural looking and adds subtle volume and plumpness to facial tissue with little to no downtime. Since the gel is softer than most other products on the market, it integrates into facial skin more easily and adapts well to facial contours. Patients treated with Belotero have stated that they see immediate results with reduction and softening of wrinkles but the results are more natural and subtle when compared with other fillers. See before and after example.
Xeomin is the newest, FDA approved cosmetic treatment undergone by both women and men who wish to reduce the animation in their brows or crow’s feet, by selectively decreasing the muscle movement. Xeomin is a protein placed in the muscles of the forehead or crow’s feet around the eyes used to selectively decrease muscle function and prevent the formation of wrinkling and deep lines. Like Botox, Xeomin improves the appearance and decreases the prominence of existing frown lines, forehead furrows or crows’ feet. To maintain results, treatments should be repeated every 3-4 months.
Dr. Paz uses the Tumescent Liposuction method, which is the safest and most effective method of liposuction. In the Tumescent Liposuction technique, large volumes of diluted local anesthetic are used to “inflate” the fat layer. The fat is then aspirated (with gentle suction) through a very small cannula (micro-cannula) inserted through tiny incisions in the skin.
The local anesthetic is so effective that it eliminates the major hazard of traditional liposuction: general anesthesia. In addition, a small amount of epinephrine is injected along with the local anesthetic to temporarily shrink the blood vessels. As a result, there is insignificant blood loss with Tumescent Liposuction as compared to traditional liposuction. Downtime after the procedure is also minimal. See before and after example.
A blepharoplasty is a surgery that corrects sagging eyelids as well as bags and around the eyes. These conditions develop as a result of laxity of the eyelid skin and protrusion of fat around the eyes. The surgery is typically 1-3 hours long, depending on extent of the surgery. In a typical surgery, Dr. Paz will make incisions following the natural lines of the patient’s eyelids, in the creases of the upper eyelids, and just below the lashes in the lower eyelids. From these incisions, he separates the skin from the underlying fatty tissue and muscle, the excess fat is removed and sometimes sagging skin and muscle are trimmed. The incisions are then closed with very fine sutures, which Dr. Paz will remove two days to a week after the surgery.
Hair transplantation is an innovative procedure that is performed by taking individual hair follicles from the patient and moving them to bald or balding areas. The strip method of transplantation, the method Dr. Paz uses, involves moving a thin strip of tissue that contains hair follicles from the donor site (usually from the back of the scalp) to the area where the hair loss had occurred. The donor site is sutured and left to heal for 10 to 14 days, at which point the sutures are removed. After removal, the strip of tissue is separated into a number of smaller skin grafts that all contain hair follicle with between one and four strands of hair. The number of hairs on the grafts depends on the hair density of the donor site. Dr. Paz then makes a series of microscopic incisions in the area where the hair is thinning, and places a single graft into each of the excisions. The implanted hair follicles will be in the dormant stage of the hair growth cycle for up to three months following the procedure. Once the three months have passed, the implanted hair follicles will begin to grow just like normal hair.
Varicose and Spider Vein Treatment
Dr. Paz uses a procedure called sclerotherapy to treat varicose veins, which are enlarged veins that appear at the surface or close to the top of the skin. Sclerotherapy involves injecting a solution directly into the vein. The solution causes a mild, controlled reaction, which results in the vein walls shrinking and ultimately closing. After sclerotherapy, treated veins tend to fade within a few weeks, although occasionally it may take up to a month to see the full results. In some instances, several sclerotherapy treatments may be needed.
Dr. Paz is trained in the use of a variety of lasers for hair removal, tattoo removal and skin rejuvenation. We intend to purchase lasers in the near future, based on patient demand and interest in certain procedures. Please see the procedures he performs below and let us know what treatments you are considering.
Fraxel Laser Treatment
Fraxel laser treatment is a safe and gradual laser procedure that stimulates the body to replace aged, scarred and photo damaged skin. The Fraxel laser is a novel device that can provide the positive results of laser resurfacing using a non-invasive technique with little downtime. The Fraxel treatment is the treatment of choice for busy patients who cannot have downtime.
Dr. Paz treats brown spots caused by sun damage, aging skin, growths or a combination of these factors with C02 laser treatments. The technique directs short, concentrated pulsating beams of light at irregular skin. Laser skin resurfacing removes skin very precisely, layer by layer.
Laser Hair Removal
Hair can be removed from practically any area on your body that you desire. The type of hair removal that is ideal for you depend on a variety of factors, including your hair color, texture, and skin color. The darker, thicker and faster growing the hair, the better the lasers permanently remove hair, reduce their population or delay growth. Coarse hair, such as the armpits and bikini, generally responds well to laser hair removal. Fine hairs, such as those on the mid upper lip and the outer cheeks, tend to be more stubborn. Lasers do not work on blonde or gray hair.
Photorejuvenation is a procedure that can improve the appearance of skin that has been affected by sun damage and aging. Specifically, blotchy skin and fine lines can be reduced with a series of photorejuvenation treatments. While the results are not immediately apparent, each treatment builds upon the last and there is minimal downtime or wound care postoperatively.
Erbium Micro Laser Peel
Erbium Micro laser peel is a minimal to full epidermal laser peel that precisely removes the outermost layers of the skin. The procedure is individually tailored to the nature of the problem to be corrected: wrinkles, scars, keratosis, or pigmentation problems.
Intense Pulse Light Treatment
Intense Pulse Light Treatment (I.P.L.) is a safe and effective procedure powered by intense pulse light. With IPL, physicians like Dr. Paz are now able to achieve amazing results for improving facial wrinkles, rosacea, brown spots, dilated veins, and aging skin.
Laser Tattoo Removal
Laser tattoo removal is a type of treatment in which a high intensity laser bean selectively treats the pigment colors of the tattoo. Lasers such as YAG lasers allow for the complete erasure of many tattoos, and significant (as much as 95%) fading in difficult cases.