A: For a non-invasive option for neck tightening and crepey skin, Vivace is a device that I use extensively in my practice for this purpose. The heat from the radio frequency and the epidermal damage from the microneedling in the Vivace device stimulate collagen production to produce firmer, tighter and younger- looking skin. The skin's texture and tone is improved as well. Keep in mind that a series of treatments is required to see best results typically we recommend a series of 3-5 treatments. Micro botox, while it can help release some lines that are caused due to movement, won't work to address the crepey skin, which seems like it is your main concern.
A: IPL is not an option I would recommend for melasma, particularly given your skin type as it can actually cause a worsening of melasma. Using hydroquinone is a good first step, but keep in mind that topical products can take some time to work, so give those products at least 3-4 months before you start seeing results. If you are looking for a device treatment to supplement your home-use products, treatments with the PicoSure laser are effective for patients with melasma. This laser has been studied in Asian skin types and has shown to be both safe and effective.
A: Typically when treating acne scars with the PicoSure laser, we usually recommend 3-5 treatments. So you likely did not have enough treatments to achieve an ideal result. There are other modalities that also work very well for acne scarring. In our practice, we utilize the Vivace RF Microneedling device and often combine it with the PicoSure to tackle difficult to treat acne scars. So you could certainly consider continuing with more PicoSure treatments or consider RF microneedling instead or as an adjunctive treatment. Keep in mind that with any of these treatments, a series of anywhere from 3-6 treatments is generally recommended to achieve the best results.
A: Other than toxins such as Botox and Dysport, TempSure Envi can be a nice tool for addressing the periocular area. Another option you may want to consider is RF Microneedling with a device such as the Vivace. TempSure Envi is radio frequency only device (RF), while Vivace combines radio frequency (RF) with microneedling for rejuvenation. We've seen excellent results at our clinic, particularly around the eye area, utilizing the Vivace. Filler would absolutely not be a treatment I would recommend for this area.
A: Given the skin concerns you noted in your question, RF microneedling sounds like it would be a good option for you to pursue. Before I brought RF microneedling into my practice, I evaluated both the Secret and the Vivace, ultimately deciding on the Vivace for my practice. We have seen excellent results with the Vivace in my practice, however both the Secret and the Vivace are good devices and you will receive a good treatment from either device in the right hands. Given that these devices are pretty similar, I would encourage you to focus more on the provider administering the treatment, their experience and their results in their patients. With device treatments, getting the best treatment results is certainly partially dependent on who is administering the treatments given that there are different energy levels, needle penetration depths, number of passes etc. that your provider will have to evaluate for your particular concerns. I hope that helps.