Botox® (Botulinum Toxin Type A) is a neuromodulator that has been FDA approved for the treatment of facial wrinkles and is one of the most common anti-aging office treatments with no downtime and dramatic results. Dr. Amato is a member of the physician provider network, authorized to administer Botox® injections. Other effective neuromodulators available are Dysport®, Xeomin®, and Myobloc®. It is a neurotoxin that when injected with a tiny needle in small amounts just beneath the skin it relaxes the underlying muscles of facial expression. These muscles are responsible for deeper wrinkles of the forehead and around the eyes. Injections start to work within the first week and last about 3-4 months. Though rare, slight bruising, mild headache, eyelid drooping, mouth weakness, and hoarseness are some reported side effects.
Fillers can be used for enhancing facial features including the cheeks, thin lips, circles under the eyes, smokers lines, aging sagging and wrinkles. Some examples of fillers include high and low cross-linked Restylane®, Belotero®, and Juvederm® Voluma but newer injectables are always on the horizon. Dr. Amato has been injecting facial fillers for over 15 years and has been an instructor and lecturer on latest technologies including treatment of complications related to fillers. Treatment can often be offered on the same day as your consultation with immediate results. Bruising and swelling can last for a few days but is usually minimal. Occasionally, inflammation, allergic reaction, nodules or infection can result, but these side effects are rare. Many of these injectables can be reversible. Dermal fillers can be applied to many areas of the face including lower eyelids, lips, midface, and around the mouth and eyes to create a natural, more youthful appearance.
With the aging face, the descent of the cheeks and skin laxity on the lower lids create a puffy lower eyelid and/or a deep groove below the puffiness resulting in a sunken, tired, or older appearance to the lower eyelid. Dermal fillers are an easy office procedure that can provide immediate improvement of the deep circles under the eye creating a more youthful, refreshed appearance in minutes. Downtime can result for a few days from bruising or swelling. A combination of skin care, fillers, laser Co2 resurfacing, fillers or surgery are options to improve the lower eyelids or tear trough region. Consultation with an eyelid specialist such as Dr. Amato can help guide you to choose the right procedure best suited to your needs with realistic expectations for a safe and natural result. Dr. Amato offers same day treatments and no consultation fee for these patients.
TCA (Trichloroacetic acid) is the active ingredient in a chemical peel that is one of the gold standards for skin rejuvenation. It can be applied to the hands, face, and neck to improve skin’s appearance, reduce fine lines and fade sun and age discolorations. Dr. Amato offers a 25% peel, which is considered a medium concentration, which she feels provides safe, effective results. For better long-lasting results following a TCA peel, it is recommended to prepare the skin before the treatment. This will allow deeper penetration and can also help speed up the recovery time and lower the risk of skin discoloration. Six weeks to a month before the TCA peel, begin with a daily application of Retina-A, glycolic acid, and bleaching agents. Retina-A will induce shedding of the dead superficial layers of skin and will later allow the TCA peel to penetrate more deeply. Retina-A will also stimulate the skin to regenerate and heal faster. Alpha Hydroxyl Acids (AHA), such as glycolic acid, will enhance the effects by removing the most superficial skin layer, enabling the TCA to penetrate deeper. Dark skin is at increased risk for developing blotchy skin discoloration of the after TCA peel. Bleaching agents can be used before and after the TCA peel to reduce this problem. If a TCA peel is performed without proper preparation the results may not be optimal, recovery may be longer, and the risk of skin discoloration is greater. Additionally, it is crucial to avoid overexposure to the sun for a few weeks prior to the treatment.
- What is the TCA peel procedure? A TCA peel can be applied in an office setting or during eyelid or facial surgery. Once it is applied, there is a burning, tingling sensation. Once it has reached the desired depth, a neutralizer such as iced saline (or baking soda in water) is used to stop the effect of the TCA and provide relief. A white frosting may occur on the skin. Usually, the face will return to its normal color within an hour of the treatment, and the client is supplied with given an ointment to apply. There should be no discomfort after the procedure is over.
- What is the TCA peel recovery? The expected downtime following a TCA peel is about a week during which most people will avoid appearing in public due to the skin hardening/crusting, cracking and peeling. During this time one must keep the skin moist using antibacterial ointments and prevent exposure to the sun. Makeup can be applied once the skin has finished peeling. One can resume their regular skin care regime within two weeks post-treatment. The flushed appearance of the skin should dissipate within a few weeks post the TCA peel. Once the old skin has peeled, the new skin will be bright and glowing.
Dr. Amato believes that excellent skin care compliments any surgical procedure prevents changes from aging and sun exposure and preserves the longevity of a more youthful appearance. An excellent sunblock and moisturizer is the foundation of skin care, but other anti-aging products such as anti-antioxidants and retinol can further enhance your appearance. Dr. Amato offers skin care products from Skin Ceuticals and Elta MD®, and also works closely with local dermatologists and med spas for a range of products and services.
Bimatoprost ophthalmic solution 0.03% is the first FDA-approved daily treatment to grow eyelashes for people with inadequate or not enough lashes. Lash Boost is also an effective lash growth enhancer by Rodan & Fields that is offered. Results can be seen in 3-6 weeks. Seek a consultation with Dr. Amato for evaluation and prescription. With daily application, results typically take up to 10 weeks for thicker, longer lashes and can have long-lasting effects. These eyelash lengtheners are safe for most people. However, you may not be a candidate for it if you have specific eye problems (such as uveitis and conjunctivitis), a risk for macular edema, severe allergies or skin infections of the upper eyelids.
Kybella®(deoxycholic acid) is a specialized injection is performed that reduces mild-moderate fat volume below the chin and upper neck to reduce a double chin and minimizes neck fullness. This is an office procedure that takes about an hour showing results in 1-2 weeks. Patients would come in for an initial complimentary consultation to see if they are a candidate for the procedure and discussion of the risks and benefits of the procedure. It is not recommended for patients who have had an infection in the treated area. Swelling, bruising, and redness typically occur for 2-5 days after the procedure. Optimal results reducing the fat cells may take more than one treatment, but the final outcome can be dramatic.
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If you are ready to take the next steps, or simply want more information about a procedure, please contact our team! Dr. Amato looks forward to speaking soon.