Ramandeep Sidhu, MD

Great question! Filler is a temporary fix, we highly recommend doing a skin treatment as well to stimulate your own collagen. This would include PRP micro needling or a laser treatment including the 1540 laser. This will also make the filler last longer and give optimal results. The nasolabial folds (the lines around the mouth) are due to aging and decrease of collagen from the cheek area. We focus on the cheeks to lift up those folds. Making sure you have a great sunscreen like Elta MD that has Zinc or Titanium will help product against the UVA sun rays that kill collagen.

These area keratin deposits under the eye. This is due to a build up of dead skin cells being trapped under the skin. Lightly exfoliating with warm wash cloths and even using a salicylic acid or retinol can help. Wash your face twice a day with your cleanser and do not put your face moisturizer under your eyes as this can clog pores as well. Instead opt for an eye gel and use this twice a day. The skin under our eyes is way more delicate than the rest of our skin. Our normal face moisturizers can be too thick for this area and clog pores.

These are great questions! Microneedling is actually a wonderful treatment option for hypertrophic scars. What we are trying to do is remodel the scar tissue and reorganize it. This helps minimize the scar and make it less noticeable. Adding PRP (platelet rich plasma) to the microneedling optimizes results so I would highly recommend doing that to get the best outcome. Another option is Kenalog steroid injections that can be injected into the scar to flatten them.

There are quite a few modalities that help with collagen remodeling and therefore improve the appearance of your scarring. 1540 Non- Ablative lasering is an excellent option and generally takes about 3-6 treatments for optimal results. PRP Microneedling and Microneedling are also great options that use controlled microinjuries to stimulate and form stronger and healthier collagen (will need 4-6 treatments). PicoSure laser is another laser that uses pressure to break up disorganized collagen and help stimulate new collagen.

You can always use a pigment gel or retinol if you want topical products. Make sure to stay out of the sun and wear sunscreen. Chemical peels would also be beneficial. For laser treatment we could use the PicoSure laser or the 1540 to help with the discoloration and remodel the scar to make it appear smaller and lighter.

Great question! Profound uses radiofrequency & microneedling to help stimulate collagen and elastin, both components which are crucial for improving laxity and dimpling. What makes Profound superior is that the physician/doctor performing the treatment can control the temperature of the treatment and length of time that particular temperature is applied to the collagen (up to 4 seconds). Profound treats dimples/cellulite as well as laxity.

Freckles are considered sun damage, and for those who are of Asian ethnicity and have sun damage or hyperpigmentation we strongly recommend PicoSure facials! This laser is safe for all skin types and targets hyperpigmentation/ sun damage, scarring, irregular skin texture, enlarged pores and also stimulates collagen. We recommend a series of at least 3 treatments, 4 weeks apart and we do not use numbing cream but have the Zimmer (blows very cold air).

Facial veins are common and at our practice we have two modalities to treat facial veins. Facial veins can be treated with facial sclerotherapy or with lasers (Nd:Yag 1064), the treatment depends on the location and the size of the vein.

These are great questions! The white ink is difficult to predict how it will respond to the laser. It can oxidize and appear more yellow because white reflects the laser and does not absorb it. However there is not much white in the tattoo and the PicoSure would target all the other colors in the tattoo. We recommend starting with 6 treatments and see how much clearance of the tattoo you get. It's also great that the tattoo is on your ribcage, as tattoos near the heart respond quicker. Price varies upon location, device used, and who is performing the treatment.

Melasma can never be permanently removed, with treatments and the correct skincare though you can suppress the melasma. The most important factor to keep melasma at bay is to avoid direct sun exposure, so make sure to wear SPF 40+ everyday and reapply every 2 hours. Others factors such as variations in hormone levels and stress can also worsen melasma. Avoid treatment such as IPL because the heat from this treatment can also worsen melasma. A good skincare regimen using the PicoSure, PCA skincare (HQ free pigment gel), and PCA chemical peels will help suppress the melasma.