In Los Angeles, patients often ask their dermatologists how to treat eye wrinkles

Fine lines under the eyes are among the very first signs of aging that people notice as they get older.  Sometimes, these are noticed as early as the teen years.  If left untreated, they can progress into more prominent wrinkles.

According to dermatologists, this is because the tissue in this area is quite thin and the collagen and elastin fibers here are more vulnerable to damage.  Skin is able to maintain its firmness and elasticity due to these protein networks .

Patients we meet here in Los Angeles, sometimes wonder if rubbing the eyes causes wrinkles. This really depends on the integrity of the collagen and elastin structures in the dermal layer.

Dermatologists would explain that if you rub your eyes, for example, the skin should be able to resume its original form.  But if collagen and elastin fibers are damaged, wrinkles around the eyes are likely to appear since the skin would not be able to bounce back and regain its original form.

While there are multiple reasons for the degradation of these skin fibers, UV rays can be considered to be at the top of this list.  Wrinkles are strongly linked to sun damage. Secondary to this would be free radicals from food sources.

While dermatologists would recommend that patients apply sunscreen (30+ SPF) on a daily basis to prevent fine lines and deeper wrinkles, correcting existing photo damage should be considered if wrinkles around the eyes are a concern.

Fraxel laser systems like Repair and Dual can help the skin under the eyes become tighter and regain its firmness. They work by applying heat to the dermal layer which then causes the skin tissue to synthesize healthy new collagen fibers.  This is a more realistic way to get rid of lines, especially those under the eyes.

Rosacea is a condition marked by skin redness. While it often affects the face, it can occur on other parts of the body as well. The patient in this video was diagnosed as having an atypical form of rosacea. He sought the help of Dr. Umar because the redness on his chest seemed to be getting worse.

The patient was treated with the Vbeam laser which is specialized for the purpose of treating vascular issues like Rosacea. It is a pulsed dye system where laser energy is administered as short, quick bursts. The patient usually feels a sensation similar to a snapping rubber band.  The Vbeam laser the 595nm wavelength which is easily absorbed by the oxygenated hemoglobin in the blood. Using a specific wavelength for a particular treatment helps ensure a highly targeted treatment that does not affect surrounding areas of tissue. Once inside the blood vessels, the laser energy seals them off so that they are no longer functional. The body’s natural waste disposal system then eliminates them.

Prior to applying the Vbeam laser as a formal treatment on this patient’s chest, Dr. Umar tested two different settings on different areas of skin. Since there were no adverse effects from this, Dr. Umar decided to treat the entire chest area. Three sessions were needed to completely clear the skin and eliminate the redness.

Some of the Rosacea had spread to the neck area. In the video, Dr. Umar applied the Vbeam exclusively to the chest. In comparing the two areas, the effectiveness of the treatment is quite evident. The chest had resumed its normal skin color, while the neck had remained red.

Although IPL is offered as a Rosacea treatment it is not specialized for the purpose of clearing skin redness. IPL uses several different wavelengths to help with general improvements in the skin’s appearance.  The results are less predictable than applications with the Vbeam laser.

In addition to Rosacea, the Vbeam laser is also ideal for facial flushing as well as Poikiloderma.

According to the patient in this video, many people, including medical experts believe that there is no solution for advanced manifestations of acne keloidalis nuchae

However the enlarged tissue mass that occurs in advanced stages of Acne Keloidalis Nuchae can be removed through surgical excision. However, the procedure needs to be performed properly  in order to prevent the symptoms from re-appearing.

Prior to seeing Dr. Umar, the patient in this video underwent an initial surgery to clear the acne keloidalis nuchae from the back of his head. According to his testimony, the wound was not closed during this procedure. And six months later, he noticed the scar area started to swell with the re-emergence of AKN bumps. As you can see from the video, the scar from the first surgery was not a linear line, but was left as an open area. The original intent was to simply allow the formation of scar tissue in the excised area.

However, due to the return of the AKN bumps, a second surgery was necessary to clear the lesions. Dr. Umar excised the affected area and applied proper techniques that facilitated the closing of  the wound.  This resulted in a horizontal scar that was strategically positioned at the base of the patient’s posterior hairline so that it is less noticeable.

The patient was quite happy with the cosmetic appearance of the results. But on an emotional and psychological level, he felt more confident. There was no longer a need to feel self conscious about people noticing the AKN on the back of his head.

Los Angeles dermatologists use Radiesse as a non-surgical rhinoplasty alternative for certain cases

The decision to undergo surgical rhinoplasty is one that requires serious consideration since the procedure is quite costly and the results are permanent.

However, if you are not happy with your nose, Radiesse injections might be a suitable alternative to a nose job, but without the surgery.

Radiesse is a dermal injection made of calcium hydroxyapatite particles suspended in a gel medium.  Calcium hyroxyapatite is a compound that is naturally found in our bones. Once it is injected beneath the skins surface, the practitioner then molds it into the shape that is needed.   The particles form a structural matrix that stimulates the formation of new collagen fibers. This property makes it suitable for correcting structural issues in the face.

Los Angeles dermatologists use Radiesse injections to achieve the corrective objectives of a nose job without surgery.  However, since there are many ways for reshaping the nose, there are only certain cases where Radiesse might the ideal recommendation. For example, it can create a straighter contour for noses with a bump or other form of deviation.  It can also correct noses with a droopy tip. Radiesse can even be used to form a higher nose bridge.

There are other types of nose corrections where the patient wishes to reduce the size or width of their nose.  Some people want a smaller slimmer shape. Others may want to eliminate or reshape the bulb at the end of their nose.  Radiesse will not be able to help in cases that require the elimination of tissue.

Since injections last 12-18 months, using Radiesse as a nose job alternative can be a suitable way to experiment with a particular nose shape.  There are many cases where patients are unhappy with the results of their rhinoplasty, which of course is permanent. So the opportunity to see if a particular nose shape will work for one’s overall appearance can be quite valuable in the long term.

And for those individuals who ended up with unsatisfactory rhinoplasty outcomes, Radiesse injections can also be used to make corrections and refine the shape of the nose where it is needed.

The average cost of treatment sessions runs between $900 to about $1500. However the financial considerations of Radiesse make it a far more economical option compared to surgical nose job costs which are usually around $4500-$8,000.

So if you are not emotionally or financially prepared to commit to an actual rhinoplasty procedure, Radiesse is certainly an option that can produce wonderful results for the time being.

Patient before and after his second surgery for treating Acne Keloidalis Nuchae

When Acne Keloidalis Nuchae is left untreated, it progresses into more advanced stages that are characterized by large tumor like masses of tissue on the back of the head. At this point, surgical excision is the only way to remove these manifestations of the condition.

While surgery does offer immense hope for AKN patients, proper techniques must be used to prevent the recurrence of lesions.

This patient underwent two surgical procedures before the back of his head was finally cleared of Acne Keloidalis Nuchae. During his first surgery, the affected area was excised. However, the physician allowed the surgical wound to heal through the formation of scar tissue as opposed to applying techniques that would allow the excision to close. This is referred to as healing by secondary intention.

However, six months after the procedure, the patient noticed new AKN bumps forming on the scar. He then sought the help of Dr. Umar for a second surgery to clear the reemergence of the new lesions.

Again, the area affected by the AKN symptoms had to be excised. Dr. Umar applied specialized techniques that would allow the wound to close, resulting in a linear, horizontal scar that would be in alignment with the patient’s posterior hairline. The appearance of this outcome is far more acceptable cosmetically. The wound closure process took about two months.

As a result of this strategy, the patient was quite pleased with the results. One of his main concerns was the social discomfort he experienced from the Acne Keloidalis Nuchae tissue mass on the back of his head, since this was very noticeable. Clearing the lesions enabled him to feel more confident in social situations.

Do your research to see which cosmetic procedure loans will be compatible with the office of your dermatologist

Many of the newest medical innovations in skin rejuvenation such as lasers and fillers are reasonably affordable as one time treatments. However, some patients may require a series of ongoing visits to their dermatologist to achieve the results they want. So it may be worth the time and effort needed to research the best options for financing these cosmetic procedures.
Financial plans for cosmetic treatments can be outlined in ways that are obscure and convoluted. So it is important to list out and structure your own criteria for considering these plans. Be sure to get a clear picture of what the interest rates are, how much you can afford in payments and how long it will take to pay off the loan.
Also some dermatologists and physicians may not accept the financing plan you choose due to the fees they would have to pay to your lender. So this of course would be another consideration to take into account.
General medical financing plans are unsecured loans. In other words, collateral is not required as security. Instead, interest rates are high, ranging from 5.66% to 27.99%. Getting approved requires good credit standing as well as minimal credit card debt (usually under $15,000). These general plans may or may not cover the cost of elective procedures. So you should also look into specialized cosmetic surgery finance companies and see which ones will work with your dermatologist.
Plastic Surgery Portal.com recommends these companies for cosmetic surgery loans.

1. American Benefit Credit
2. Chase Health Advance
3. Cosmetic Surgery Financing
4. Health One Financial
5. Surgery Loans
6. Cosmetic Credit
7. Med Choice Financial
8. Care Credit
9. Med Loan Finance
10. My Medical Loan
Provided that your income is stable, the right plan can enable you to finance the procedures that you want to have done so that you can enjoy the results sooner as opposed to later. However, thoughtful consideration, foresight and research are key to making the best decisions.

Dermatosis Papulosa Nigra affects about 35% of the African American population

Dermatosis Papulosa Nigra is a benign skin condition that manifests as black or brown papules on the skin that are flat and raised from the surface. These mole-like bumps are usually between 1-5mm in size. They are typically seen on the cheeks, forehead, neck and torso.  For some patients, DPN occurs as under eye moles.

Causes

Dermatologists are not clear as to the exact causes Dermatosis Papulosa Nigra. One possibility is that that the pilosebaceous follicle does not develop properly.  Also, it is likely to be linked to a genetic predisposition. Research shows that 40-50% of patients have a family history of this condition.

Dermatosis Papulosa Nigra has three levels of severity:

1. Mild- less than 10 papules
2. Moderate-more than 10 papules
3. Severe-more than 50 papules

Epidemiology

This skin condition occurs in about 35% of the black population and an unknown percentage of Asians. Women are usually affected more than men.  Symptoms are apparent starting in adolescence. With age, the papules increase in number and size.

The Nd:YAG laser for Treating Dermatosis Papulosa Nigra

Because DPN is a benign condition, patients seek treatment help from dermatologists for cosmetic reasons. In recent years the Nd:YAG 1064nm laser has shown to be a promising treatment for DPN. Older methods include: curettage (scraping), cryosurgery (freezing), and electrocautery (burning). However these modalities pose risks of scarring, the formation of keloids and unwanted pigmentation issues.

Because the 1064nm wavelength is safe for dark skin, the long pulse mode was studied as a way to coagulate the melanin of the dark spots and any blood vessels supporting the growth of the mole-like lesions. This coagulation results in the elimination of the resulting waste tissue by the body’s natural system.

In 2008, the Journal of Cosmetic and Laser Therapy published a study on the use of the Nd:YAG laser in the treatment of Dermatosis Papulosa Nigra. The dermatologists involved in the research reported successful results in clearing the lesions from two patients.

In 2009, the Institute of Laser at the Sudan University of Science and Technology  also published research on using the Nd:YAG laser on 20 subjects.  The outcome was also successful in this study as well.

Los Angeles dermatologist, Dr. Umar uses the Nd:YAG laser to successfully treat  Dermatosis Papulosa Nigra, related vascular and pigmentation conditions as well as numerous other cosmetic objectives. It is safe for all skin colors while providing excellent results.

In the field of dermatology and other areas of medicine, lasers function as a non-invasive tool that adjustments and corrects tissue at very specific, microscopic lasers. There is usually very little pain involved and minimal side effects.

Los Angeles patient with rosacea before and after Vbeam treatment

Poikiloderma and Rosacea are both vascular conditions that result in skin redness. Eliminating the symptoms means eliminating the blood vessels responsible for causing them.

Botox and Dysport injections target the muscles responsible for causing standard facial lines that manifest with age. These wrinkles include horizontal brow furrows, frown lines (glabellar lines) and crows feet.  For some people, horizontal lines develop over the top part of the nose bridge.

Los Angeles dermatologist, Dr. Umar explains what muscles receive Botox and Dysport injections, since these are involved in creating unwanted wrinkles by creasing the skin.

Corrugator muscles  which are responsible for vertical frown lines contract towards the center of the forehead.  Horizontal worry lines occur from the contraction of the frontalis muscles on the forehead.  Crows feet are caused by the muscles around the eyes (also known as orbicularis oculi muscles). They are also caused by the elevation of the cheek muscles when we smile. However Dysport and Botox are injected in the eye muscles responsible for the development of crows feet. They are not injected into the cheek muscles.

The results of Botox and Dysport will differ with individual patients. If patients do not receive the results they want with Botox, Dysport can be considered. And if they receive Dysport without experiencing satisfactory results, Botox should then be considered.

According to the patient in this video, Dysport substantially outperforms Botox. He had Botox injections in the past and decided to try Dysport for crows feet, forehead lines and frown lines. His testimonial was given about 2-3 weeks after this treatment.

In observing the effects of Dysport, he mentioned that he noticed his facial lines started disappearing within hours of the procedure. And also the vertical glabellar lines between his brows had also disappeared. In his case, these were the most stubborn and difficult wrinkles to address, even with Botox. However Dysport managed to eliminate these lines. Interestingly, his wife also experienced frustration in trying to eliminate the same wrinkles between her brows. And after her Dysport injection (which was on the same day), she noticed that they disappeared rather quickly and effortlessly.

Because of these experiences, this patient has conclusively decided that Dysport is “quicker and superior” to Botox.

Please note that individual experiences will differ due to physiological reasons. So if Botox does not deliver desired results, Dysport should be considered as an alternative and vice versa.