Brynn Richardson, MD

SkinTyte is easy as pie. To reiterate, the technology utilizes near infrared energy to gently heat tissues. Heating to a specific temperature target range causes collagen contraction while simultaneously stimulating your skin to produce its own collagen/elastin giving an overall improvement to skin tone and firmness. It takes several sessions and the final results build over several months. Generally, you should maintain your results for 1.5-2 years. Depends on age, diet, activity levels.

The actual procedure uses the BBL handpiece and this is what you experience: the area to be treated is measured out in either 25, 50, 75, 100 square centimeter increments. Gel is applied and the handpiece is moved back and forth over each segment until the target temperature range (40-42 degrees Celsius) is reached. this is checked periodically with an infrared thermometer.  The tissue is then held in this temperature range for several minutes until a target number of joules is delivered in that segment. You will notice the skin gradually heat up in the area. Numbing cream is generally not needed unless treating more sensitive areas like the under eye or labia. (Yes, skintyte can be used on the labia as an alternative, non-invasive procedure for labial tightening. Its known as DiVaTyte and its awesome. No downtime. Say good-bye to surgical labiaplasty).

Afterwards, the skin may be slightly tender but generally there is NO downtime. 

Thanks for the question.

Best,

Dr R

Thanks for the question and photos. I am not a provider in your area, but would like to offer some advice here--whether you do indeed stay on the non-surgical train or go the surgery route.

First, judging from your photos provided, you really do need to consider restoration of volume to the mid and lower face. That's true whether you consider surgery, or not. It will help cut down the appearance of 'peanut face', reduce the drag on your lower lid (which makes one look really tired) so the junction between your lower eyelid and cheek are restored to a more youthful anatomic position, and reduce jowling. I really, really like the baseline volume restoration provided by a series of Sculptra injections. I often follow this with a small amount of filler to address more stubborn areas of 'static lines', such as the nasolabial folds. 

Second, you also have a component of dynamic lines on your forehead, 11's, and crows for sure--that's a neuromodulator issue (Botox, Dysport). Anything you do from the standpoint of skin improvement or volume restoration will be better maintained if you treat the areas with a neuromodulator. 

Third, the icing on the cake would be a laser resurfacing procedure, especially around your mouth/lower face. The result you achieve there is dependent on the amount of downtime you are willing to commit and if you're willing to go through repeat procedures in a series. Deep resurfacing (erbium, CO2) is lots of downtime but oh so beautiful result and typically one and done.  Fractional resurfacing (halo, Fraxel) is less downtime, but also less result and honestly, requires a series of sessions to achieve what deep resurfacing does in one. There are certainly other technologies (radiofrequency alone, micro needling paired with radio frequency, PRP...) but, again, multiple sessions needed to achieve a decent result. Its truly in your court to balance your goals with the treatment modalities you elect to employ.

Best,

Dr R

 

Hello and thanks for posting your question. When used in the hands of an experienced provider, BBL is really quite safe and effective at reducing (and often eliminating) concerns relating to pigmented lesions, vascular issues (vessels, telangectasias, cherry angiomas, rosacea), and altering gene expression for maintaining more youthful skin. 

The thing that most patient concerns have in common is that the 'target' (brown spot, vessel....) has a 'color'. With respect to hypo-pigmented areas, depending on how depigmented an area is, its going to present relatively less 'target' and take up less of the light. It will take up some, and there's certainly a small possibility the area could 'clean up' a bit and look lighter, if in fact there is some subclinical (not as visible) sun damage present. The areas of more concern, or brown spots, can be targeted in a more focused manner and the treatment settings can be tailored to provide more effect. 

With a good provider, its likely the overall result will be pleasing to you. Do your homework and make sure you're in the hands of an experience provider!

Best,

Dr R

Lasers have really almost entirely done away with chemical peels for the treatment of wrinkles. On the whole, one can achieve far greater results with far better control utilizing a laser.

The real questions most patients need to consider when looking at one treatment over another (say different lasers) is 'What is my desired result?' and 'What is my tolerance for downtime?'. It can be a challenge to balance the two questions and in the end, more downtime usually equates to more result, faster. Certainly, more gentle treatments with lesser amounts of downtime can eventually lead to good results, however, the trade-off is often a series of procedures v one. 

Deep resurfacing with erbium, or CO2, is the gold standard for deep lines. Most patients would consider the downtime involved to be fairly extensive and the redness of the treated areas to be fairly prolonged. The results are beautiful and this is usually a one and done treatment. Not every patient is a candidate for deep resurfacing due to skin type.

Fractional lasers are basically all going to require multiple procedures stacked a couple months apart to get to a nice result. A patient's hide out time is generally much shorter and easier to conceal overall. By the time you consider multiple treatments, the costs of fractional resurfacing vs. deep can be fairly even.

And, sometimes a filler is still needed to augment the result. And, often patients should consider neuromodulators (Botox, Dysport, etc.) to help maintain the result. The answer isn't necessarily quick and easy. 

Best! 

Dr R

When in doubt, get another opinion. This applies to multiple points of your submission. Patients presenting with concerns regarding new or changing skin lesions can often be accurately diagnosed and reassured by physical examination alone. However, you are correct in your assertion that no diagnosis is ever certain without tissue (i.e. biopsy). The good news is biopsies can often be achieved with minimal scarring. 

There are a number of options for skin lesion removal, whether these are flat or raised and depending on a patient's preference/goals. Excising/biopsy is always an option but carries with it the resulting scar. If scarring is unacceptable, those lesions that are flat and pigmented often respond to treatments such as BBL/IPL series. For raised lesions, BBL/IPL is still an option but the patient must be aware neither will usually address the raised nature or texture to any degree. Occasionally, an early seborrheic keratosis will flake entirely off, but not reliably. Raised lesions most often need to be treated with an ablative spot laser treatment such as erbium or CO2. Hope that helps!