Ablative Resurfacing

Skin treatment with laser, plasma, chemical, or mechanical abrasion that removes the outer layer of skin (epidermis and part of the dermis) with a week or greater of time before the new skin entirely forms. During the week without an outer skin layer, the patient must use liberal amounts of skin emollients to serve as skin barrier and to facilitate smooth healing. Although the downtime is more significant, the results are generally much more significant than with non-ablative resurfacing (See Non-Ablative Resurfacing).

Accent XL

A two-way radiofrequency device used to improve skin texture and tone as well as to reduce fat and cellulite.

Accutane

Brand name for isotretinoin, which is a very strong medication prescribed by dermatologists to treat severe cystic acne. Patients who have had Accutane in the past are ineligible for skin resurfacing for a minimum of a year but more likely 18 months since the sebaceous glands have been reduced – which are the source for new skin formation. Interestingly, fat grafting which does not require any formal incisions is safe.

Allergan

Allergan is a company that merged with Inamed and produces many products in the cosmetic market, including BOTOX ® and Juvéderm®.

Bellafill

An injectable agent combining bovine (cow) collagen and methylmethacrylate (plastic) beads to provide a permanent aesthetic facial correction. Bellafill can provide long-term solutions to areas of the face that would benefit from this treatment.

Blue Light

A treatment used to treat active acne by targeting the bacteria, P.acnes, that causes acne.

BOTOX

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BOTOX ®, manufactured by Allergan, is the brand name for botulinum toxin used to treat wrinkles mainly of the upper face but also at times for the lower face. BOTOX ® can also be used for facial reshaping by lifting the corners of the brows, corners of the lips and relaxing the nasolabial fold/smile line. BOTOX ® lasts typically between 3 to 4 months in most cases. BOTOX ® works by blocking a treated muscle from moving in order so that wrinkles will start to diminish over time, bad habits like chronic frowning are slowly forgotten, and even the texture and tone of the skin can improve over time. Dr. Lam believes in the importance of BOTOX ® being a long-term regimen for the improvement in facial wrinkles and skin health.

Botulinum Toxin

See BOTOX ®

Calcium Hydroxylapatite

See Radiesse

Captique

A type of hyaluronic acid (See Hyaluronic Acid) injectable that has a higher water content and a much lower concentration of hyaluronic acid that leads to minimal to no swelling after injection but very little longevity. Given its relatively short longevity (oftentimes several weeks), Dr. Lam no longer uses Captique.

Carbon Dioxide Laser

Considered the “gold standard” for skin resurfacing. Introduced in the early 1990s but today considered aggressive in terms of long-term risks of skin color loss and also prolonged recovery time of several months.

Chemical Peel

Use of a chemical agent like trichloroacetic acid (TCA) to treat skin pathologies and aging. Low concentrations of TCA like 10 to 20% used lightly can be non-ablative (See Non-Ablative Resurfacing) and higher concentrations used with multiple passes like 35% TCA can be ablative (See Ablative Resurfacing).

CO2 Laser

See Carbon Dioxide Laser

Bovine Collagen

Collagen that is derived from a cow source is now a relatively outdated method for cosmetic correction of the face for two reasons: 1) too short acting compared with high concentration hyaluronic acid products (HA, See Hyaluronic Acid), 2) requires a skin test a month before treatment. It comes packaged either as Zyderm I and II (thinner products for finer lines but more short lived) and Zyplast (thicker product for longer effect and deeper folds but still shorter lasting than HA products).

Cosmoderm

A type of injectable human collagen used for temporary correction of facial defects and manufactured by Inamed (now Allergan). Cosmoderm is intended for finer lines and lasts a shorter time than Cosmoplast. Both products however are relatively short lasting compared with high concentration hyaluronic acid products so Dr. Lam does not use either Cosmoderm or Cosmoplast.

Cosmoplast

A type of injectable human collagen used for temporary correction of facial defects and manufactured by Inamed (now Allergan). Cosmoplast is intended for deeper lines and lasts a longer time than Cosmoplast. Both products however are relatively short lasting compared with high concentration hyaluronic acid products so Dr. Lam does not use either Cosmoderm or Cosmoplast.

Dermabrasion

Mechanical dermabrasion should not be confused with microdermabrasion. Microdermabrasion provides light exfoliation and is a spa/aesthetician treatment. Mechanical dermabrasion is a procedure that sands away the outer layer of skin in an ablative fashion (See Ablative Resurfacing) used to improve the condition of scars or previously uneven surgically treated areas.

Dysport

The British version of BOTOX ® manufactured by Ipsen to be released in the United States as Reloxin by Medicis. Currently, not FDA approved for use in the United States.

Fotofacial

See IPL

Fractionated Laser

A semi-ablative treatment in which micropunctures with a laser are undertaken in a grid pattern so that the skin will heal in a non-ablative fashion with results that can be halfway between non-ablative and fully ablative skin treatments (See Non-Ablative Resurfacing and Ablative Skin Resurfacing).

Fraxel

A brand for a type of fractionated laser treatment. See Fractionated Laser.

Hyaluronic Acid (HA)

A polysaccharide composed of the same molecular structure across all species used as an injectable filler in products like Restylane®, Resylane Lyft , Juvéderm®, Hylaform, and Captique that does not require any skin testing before treatment. Can be used in all facial areas and benefits from low allergy profile and reversibility with Vitrase (See Vitrase). Higher concentration HA products like Restylane®, Resylane Lyft , and Juvéderm® are hydrophilic in that temporary swelling for 2 to 3 days is normal and will dissipate shortly thereafter.

Inamed

A company that manufactures cosmetic products and that has been purchased by Allergan (See Allergan).

IPL

IPL stands for intense pulsed light and is also known as fotofacial or photofacial. Intense light that is used to treat the skin in a non-ablative fashion (See Non-Ablative Resurfacing) principally to treat color problems like unwanted brown and red color and to a lesser extent wrinkles and texture/tone.

Juvéderm

®
A hyaluronic acid product that comes in two thicknesses Ultra (thinner) and Ultra Plus (thicker) used as an injectable agent to fill lips, volume loss, and wrinkles.

KTP Laser

A laser at 532-nm used in a non-ablative fashion (See Non-Ablative Resurfacing) to treat principally red lesions like telangectasias, broken capillaries, and spider angiomas but also can be used to treat superficial brown spots like freckles.

Laser

A monochromatic (one wavelength), coherent (wavelength in sync and in one direction) Light that is Amplified by Stimulated Emission of Radiation (hence the name L-A-S-E-R) used in a variety of capacities but in this glossary used to treat one’s skin. Through a process of selective photothermolysis, lasers of different wavelengths are used to target different skin pathologies depending on the wavelength

Medicis

A company that distributes Restylane® and Resylane Lyft and soon will release a competitor to BOTOX ® called Reloxin.

Non-Ablative Resurfacing

Non-ablative resurfacing refers to a skin treatment in which the outer layer of the skin is maintained and not effaced (removed). Examples would be a photofacial or light chemical peel that can help improve the skin without significant downtime. Generally, non-ablative resurfacing is not as effective as ablative resurfacing (See Ablative Resurfacing) for deeper signs of skin aging but can actually be more effective in treating color problems of the skin than ablative resurfacing with certain types of non-ablative lasers.

P.acnes (Propionibacterium acnes)

The principal bacteria found in acne that can be treated with a variety of methods: tetracycline antibiotic, benzoyl peroxide, and blue light therapy.

Resylane Lyft

A thicker form of hyaluronic acid used for the treatment of deeper wrinkles, volume loss, and skin folds made by manufacturer Medicis.

Photofacial

See IPL

Pixel

A type of fractionated laser treatment. See Fractionated Laser.

Plasma Skin Resurfacing

Plasma skin resurfacing refers to a type of skin treatment that can be either ablative at high settings or non-ablative at low settings (See Ablative Skin Resurfacing and Non-Ablative Skin Resurfacing) aimed at managing wrinkles but principally to provide a much improved texture and tone to the skin. Plasma refers to the energized state of nitrogen gas that is the delivery system for the Portrait device which is administered to the patient in a non-contact fashion. Skin improvements can be observed up to a year and beyond following treatment.

Poly-L-Lactic Acid

See Sculptra

Portrait Plasma Skin Resurfacing

See Plasma Skin Resurfacing

Radiesse

Radiesse, formerly Radiance, is composed of calcium hydroxylapatite, a material found in the human body, which is used as an injectable agent to provide long-term (8 months to 14 months in general) correction of volume loss and deep folds but is relatively unsuitable for treatment around the eyes and in the lips.

Radiofrequency

An alternative to a laser that treats deeper skin tissues through the use of radio waves. See Accent XL.

Restylane

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A hyaluronic acid product (See Hyaluronic Acid) used to treat all types of aesthetic deficits including lip enhancement, line improvement, wrinkle reduction, and volume filling – although Resylane Lyft (See Resylane Lyft ) is more ideally suited to the latter indication. Restylane® and Resylane Lyft are distributed by Medicis.

Reloxin

A product that was marketed as Dysport by Ipsen in England and will be released as a competitor to BOTOX ® in the United States, pending FDA approval.

Rhytec

The company that manufactures the Portrait device for plasma skin resurfacing. See Plasma Skin Resurfacing.

Rhytid

The medical term for a wrinkle.

Sculptra

Brand name for injectable poly-L-lactic acid used to treat HIV lipoatrophy and off-label to treat pan facial volume loss. Dr. Lam does not use Sculptra anymore owing to four reasons: 1) expense to the patient, 2) inability to treat the area around the eyes and mouth safely, 3) long wait before results are observed and 4) unpredictability of the result.

Silicone

Silicone can be used both as a solid and as a liquid. Dr. Lam uses both types for cosmetic enhancement. Solid silicone implants can be used for chin and cheek augmentation that requires a surgical procedure to implant. Liquid silicone is used as an off label product since it is FDA cleared for intraocular (inside the eyeball) treatment of retinal detachments. Liquid silicone can be used for lip augmentation, non-surgical rhinoplasty, treatment of acne scarring, and various other cosmetic and reconstructive facial indications.

Thermage

A radiofrequency device that has been touted to provide skin tightening and rejuvenation that unfortunately has also been met with disappointment and a higher than expected complication rate in facial tissues. Has had some success in treating body areas for skin tightening and rejuvenation.

Vitrase

The brand name for hyaluronidase used to reverse hyaluronic acid products (See Hyaluronic Acid).

Zyderm

See Bovine Collagen

Zyplast

See Bovine Collagen