Edward A. Alvarez, DDS - Account Suspened

Hi, and thanks for your great question. Yes, surgeons will leave a thin layer of subcutaneous fat after liposuction to prevent an uneven appearance to the skin, or the peaks and valleys of the canula. What we have seen in our practice is that TruSculpt ID is great at evening out that small layer of fat that can still remain over the abdomen. It will also tighten the skin in that area due to the RF energy and heating of the tissue, so you will get a better overall appearance.

Now, as for your question of depth. The histological studies from Cutera, the maker of TruSculpt ID demonstrate that the RF energy that kills the fat travels approximately 1.5cm, or a little more than half an inch beneath the skin's surface. So, the answer is no, it will not reach visceral fat. The only way to remove visceral fat is via diet and exercise.

I hope this gives you a better understanding of TruSculpt ID, and helps you make a better decision.

Kind regards,
Dr. Edward Alvarez
Diplomate, American Academy of Aesthetic Medicine
Member, American Academy of Cosmetic Surgery

Hi, and thank you for your question about the differences between TruSculpt Flex, TruSculpt ID, and TruSculpt 3D. In reality, there are only two different technologies there, TruSculpt Flex is multidirectional electrical muscle stimulation, and it is used to build and strengthen muscles. TruSculpt ID is a monopolar radiofrequency (RF) device used to kill fat and tighten skin. It has handsfree applicators that are attached to the areas you are treating, with the exception of the submental area (under the chin) which uses a handheld wand. TruSculpt 3D is a separate applicator (handheld device) that is passed over the areas you want to treat with RF energy.

If you want to build muscle, your treatment would be the TruSculpt Flex. If you want to permanently eliminate fat and tighten the skin in that area, TruSculpt ID would be your treatment of choice. I find that best results in my patients involves first treating the area with TruSculpt ID to permanently destroy the fat in the area (typically 24-28% of the fat in the treated area) and tighten the skin, and then do 4 treatments of TruSculpt Flex + to build the muscle. If you build muscle without removing the fatty tissue above them, you will be stronger, but will not necessarily show the results of muscle building.

I hope this helps and gives you a better understanding of the different technologies.

Kind Regards,
Dr. Edward Alvarez
Diplomate, American Academy of Aesthetic Medicine
Member, American Academy of Cosmetic Surgery

Hi, and thank you for your question. As someone who has experienced all three devices and had them demonstrated in my office prior to adding it to my practice, the only one that impressed me was TruSculpt Flex. That is why I added it to my practice.

EMSculpt works via electromagnetic stimulation vs. TruSculpt Flex + which is multi-directional elecrical muscle stimulation. The feeling that they produce when stimulating your muscles is different, and both will be beneficial to you. The difference for me as both a patient, and as a doctor providing the treatment to other patients, is the results that I saw. Both my wife and I saw IMMEDIATE results in muscle growth and muscle tone after doing the TruSculpt Flex treatment. We were left unimpressed with the EMSculpt results we obtained. Once we saw that, we knew it was the device we wanted to offer our patients.

Ultimately, you will have to try and see what works best for you. Hope you have a better understanding of which is best from our experience.

Best of luck,
Dr. Edward A Alvarez
Diplomate, American Academy of Aesthetic Medicine
Member, American Academy of Cosmetic Surgery

Hi, and thank you for your question. As someone who has treated many patients with TruSculpt Flex +, and someone who has personally experienced the treatment multiple times, I can say that it feels like my muscles are moving and contracting in ways they've never have. The feeling is not something you can exactly compare to the gym. The patterns of stimulation will vary throughout the 15 minute period. At one point it feels as if there is a strong tapping to the muscles, at another it will be a stretching feeling, and at another it will be twisting. The good thing is that it keeps the body guessing and it never becomes monotonous.

Before adding TruSculpt Flex + to my practice I demoed the bigger name in the muscle machine space, and was completely unimpressed. My staff and I had no problem getting to a 100% intensity, and it was boring to sit there. I felt nothing remarkable. With TruSculpt Flex + I felt, and my patients feel an immediate pump after the treatment. You can see how the muscles have been worked, and the increase in blood flow to the area. To me there is no comparison between the two. Hope this helps explain a little better.

Kind Regards,
Dr. Edward A Alvarez
Diplomate, American Academy of Aesthetic Medicine
Member, American Academy of Cosmetic Surgery

Hi, and thank you for your question. TruSculpt Flex pricing will vary based on your location, areas treated, number of treatments, and expertise of your provider. Though you will experience some results and benefit from a single treatment, the protocol is to do four treatment sessions over a period of 14 days. National average will range anywhere from $650 to $1200 per treatment.

Kind Regards,
Dr. Edward A Alvarez Diplomate, American Academy of Aesthetic Medicine
Member, American Academy of Cosmetic Surgery

Hi, and thank you for your question. We have treated many patients, and even myself with the TruSculpt Flex plus, and I can personally say that it is painless if the person treating you is well trained and professional. It will cause strong muscle contractions that will build your muscles, but at no point should they be so intense that they cause pain. I am always getting constant feedback from my patient and never leave the machine when treating them. Your treatment should be intense, but not intolerable.

After treatment, patients feel normal and are able to return to regular activities immediately. Some may develop mild soreness akin to going to the gym, but it is not typical. The only thing I recommend is that any exercise that targets the treated area is postponed for 48 hours after treatment with TruSculpt Flex.

Kind Regards,
Dr. Edward A Alvarez
Diplomate, American Academy of Aesthetic Medicine
Member, American Academy of Cosmetic Surgery

Hi, and thank you for your question. Unfortunately after completion of Invisalign some spaces may remain, but they should be closed by your Invisalign doctor. Your concerns of food getting trapped should never be dismissed because aside from aesthetics, it can create decay and periodontal issues in the future. The solution is to re-scan or re-impress you, and send back to Invisalign to create new aligners for finishing. With an Invisalign lite case, there should be no charge, if this is the first time your case is being sent for revision. In almost 20 years of doing Invisalign, I have never charged a patient additional fees for a correction or refinement. Most dentists will not either. You will have to discuss it with your orthodontist, but he or she should be amenable to making you happy. Best of luck.

Hi, and thank you for your question. After looking at your pictures, it is my professional opinion that you have two options to correct the position of your lateral incisor. The first, and best, would be to undergo some sort of limited orthodontic treatment, either Invisalign or traditional braces. That will move the position of not only the tooth in the mouth, but the root in the bone, placing it into the proper position for long term health and success. It will also avoid trimming down your tooth. 

Your second option is to have the tooth trimmed down for a veneer or crown. It will be instant gratification, as it can be done either in one visit (as I do with CEREC) or two (traditional impressions and lab), as opposed to orthodontics that will take months. The downside is that depending on how far the tooth is flared out, you may hit the nerve in the tooth when trimming to allow proper placement of porcelain, and that would mean you would need a root canal. 

Overall, I would recommend you go with orthodontics as your first choice.

Best of luck,

-Dr. Alvarez

Hi, and thank you for your question. I'm sorry to hear that you had a history of bulimia, but I am very happy to hear that you are recovered. I think to better understand your concerns you need to state what exactly you don't like about your smile at the present time. It does seem like you have some gingival inflammation from the picture, so your gum health needs to be evaluated. 

Whenever a patient has suffered from bulimia, the acid from the stomach tends to destroy the chewing and lingual surfaces of the teeth, and will thin out the enamel, many times making them weak, brittle, and translucent. Before any treatment can be advised, a full examination should be done, and then your needs can be determined. Sometimes the solutions can be simple such as home treatments with pastes and gels to remineralize your enamel, and other times you need either veneers or full coverage restorations (crowns).

Best of luck,

Dr. Alvarez

Hi,

Thanks for your question. I'm sorry to hear that you had discomfort after you had your temporary crown placed. I think your first dentist is correct in not being certain if you needed a root canal right away. A root canal is needed when you have irreversible damage to the nerve inside the tooth. Whenever a tooth is worked on, be it fillings, veneers, crowns, etc., you can many times cause a reversible trauma to the nerve. That will present as sensitivity to hot, cold, or sweet, as well as to biting. You may also have discomfort due the the seal of the temporary not being perfect, or the temporary being too high in occlusion (bite). To go straight to a root canal is wrong in my opinion. Unless the pain is constant, and severe, the proper course of action is to wait it out. As you have seen, your pain is now gone, and the tooth feels normal once again. If you want to cover all bases, have your dentist place the permanent crown on with temporary cement, and continue to follow the tooth for a month or two. If there is no further pain, then you can cement the crown. If there continues to be pain, then you should either have your dentist, or an Endodontist evaluate the tooth further for root canal. 

Best of luck,

Dr. Alvarez