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To learn more about the skin care treatments available to my Palo Alto area patients, contact my cosmetic surgery practice today.
Lauren Greenberg, M.D.
BOARD CERTIFIED, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
750 Welch Road, Suite 117
Palo Alto, CA 94304
p / 650.617.9907
f / 650.617.9909
Skin Care Treatments Available at my Palo Alto Practice
Skin care treatments provide a less invasive way for my Bay Area patients to achieve an improved appearance. These are nonsurgical treatments that can be done in my Palo Alto office. Many have no down time. These can reduce wrinkles with BOTOX® Cosmetic, improve texture and sun damage with skin care lines like Obagi® and SkinCeuticals, fill out fine lines of the lips and face and create fuller lips with soft tissue fillers like Collagen, Cosmplast™, and Restylane®, and resurface the skin with chemical peels like the Obagi® TCA Blue Peel.
- Skin Care Products
- Obagi®
- Obagi® Before and After Photos
- Obagi® TCA Blue Peel
- SkinCeuticals
- Skin Peels/Resurfacing
- Skin Cancer
Injectables and Soft Tissue Fillers
We offer various soft tissue fillers and wrinkle reducers, including Restylane®, collagen, and BOTOX® treatment, at our Palo Alto practice serving patients throughout the Bay Area.
What are soft tissue fillers? As we age, we form fine lines on the face and around the mouth. Lips lose their fullness. The cheek starts to droop, causing a deepening of the nasolabial fold. All these are subtle signs of aging, and many are due to loss of fat and soft tissue volume in the face. Collagen was the first filler to come out, and since then there has been a multitude of fillers on the market: Cosmoplast™, Restylane®, Hylaform®, and Captique™ among others. Fillers are a nonsurgical procedure I perform in my Palo Alto office. There is little to no downtime. They provide a subtle improvement in aging. For the lips, Restylane® makes the lips a little fuller and gets rid of the fine wrinkling around the mouth where lipstick bleeds. I, like most of my Bay Area patients, like a natural, non-plastic surgery look.
As far as which filler is best for you, I find different soft tissue fillers are better in different areas. There are two basic classes: Collagen fillers, like Zyplast® and Cosmoplast™, and hylaronic acid based fillers like Restylane®, Hylaform®, and Captique™. I also have found some patients do better with one filler than the other - ie. the Cosmoplast™ lasts longer in them than the Restylane®, or vice versa.
For an in depth discussion, you can come into my Palo Alto office or receive a brochure. Additionally, the website links are provided below:
Cosmoplast™, Hylaform®, Captique™: www.allerganandinamed.com
Restylane®: www.restylaneusa.com
Juvéderm™ www.juvedermusa.com
BOTOX® Cosmetic (Botulinum)
BOTOX® injections are a great way to eliminate or reduce wrinkles and frown lines. The areas frequently treated are the forehead, the lines between the eyebrows, and the crow's feet around the eyes. These lines can make you appear older, tired, and angry. It is also useful in some migraine patients to help reduce headaches. With the active outdoor lifestyle we lead in the Bay Area, squinting in the sun can make wrinkles worse. BOTOX® Cosmetic can help.
BOTOX® Cosmetic is a non-surgical skin care treatment I do in my Palo Alto office. It takes only minutes to perform the injection, and usually brings results within 72 hours. BOTOX® Cosmetic is botulinum toxin. It paralyzes the specific facial muscles, immobilizing the muscle for three to five months. As a result of the muscle not moving, the skin lying on top of the muscle relaxes and wrinkles fade. The effect is a rested and more youthful appearance. Over several months, as the muscle action gradually returns and lines reappear, a simple follow up skin care treatment is all that is necessary to regain the desired result.
It is important that you go to a doctor who is well versed in administering BOTOX® injections for a natural, smooth result. Otherwise droopy eyelids, a "frozen" face, or severe bruising may occur. I perform the botulinum toxin injections myself - "doctor administered BOTOX® Cosmetic" - I do not use nurses or assistants. Fresh BOTOX® Cosmetic is more effective, so look for a “BOTOX® treatment” day. Places that offer BOTOX® Cosmetic daily frequently use old botulinum toxin, which is not as effective. I also offer a discount when more than one area is done. For more information, visit www.botox.com.
Restylane®
Restylane® is a safe filler material used to reduce nasolabial folds and frown lines. It is made of hyaluronic acid - a naturally occurring substance in the human body that responsible for giving skin its fullness. Unlike animal-based hyaluronic acid products, Restylane® contains no animal proteins. This means that no allergy test is required prior to using Restylane®. The results have been shown to last about six months. Make an appointment for more information!
Collagen
Collagen is what gives skin, bones, and other tissues their structural support. Over time, naturally occurring collagen can begin to break down, leaving skin looking loose, lined, and flat. By injecting natural, purified collagen into the places that have lost their volume, we can reduce frown lines, crow's feet, and nasolabial folds. The results can last between three and six months.
Skin Care Products
Obagi®
I carry the Obagi® line, which is a multi-step system to healthier skin. It addresses what I consider the basic tenets of skin care:
- It exfoliates.
- It protects.
- It reverses some of the sun damage and aging of the skin.
Obagi® ( www.obagi.com) offers a fantastic line of skin care products that can really improve your skin. Obagi® products are great for normal, thick, pigmented, oily, flaky, or large-pored skin, and for all skin types, including medium and dark skin.
Skin care should start before the signs of damage are evident. We in the Bay Area are exposed to the sun and elements constantly - driving to and from work, lunchtime outside in sunny Palo Alto. I usually recommend this skin care program in their 30s or older. Benefits are seen at any age. The cleanser and toner help exfoliate, which is when the top layer of your skin turns over more frequently. This will help give you fresher, healthier looking skin, and may prevent some break-outs.
The Obagi Nu-Derm® System is a home skin health restoration program that incorporates PRESCRIPTION STRENGTH products to restore skin's health. It is designed to eliminate hyper pigmentation and photodamage (sun damage), refine skin texture, normalize oil production, hydrate skin, and give it a healthy glow. Unlike other products, Nu-Derm® penetrates the dermis and has the ability to correct many skin problems, including those deeper problems that peels and exfoliation can't reach.
As you age, your skin loses elasticity. Cell turnover and the flow of moisture from deep within begin to slow. Damage worsens from sun, stress, environment, and smoking. This system corrects surface discoloration. It penetrates the skin to stimulate skin renewal, improve circulation, and rebuild collagen. After six weeks (one skin cycle), new skin cells emerge to the surface
The sunscreen will help prevent you from getting further sun damage. Again living in California, we have constant exposure to the sun all year. Sunscreen shouldn't be just for the beach. You should wear SPF 15 or higher as part of your daily routine. Sun damage is a primary contributor to skin aging and cancers. To reverse damage, hydroquinone and Retin-A® are used. Hydroquinone is a "skin bleacher." It works by smoothing out areas of pigment irregularity and age spots. Retin-A® helps reverse sun damage, wrinkling, and age spots. It helps the deeper layer of the skin thicken and reorganize to reverse fine wrinkles. Results are seen after months of use. For more information on the Obagi® skin care system, go to www.Obagi.com.
Obagi® Before and After Photos
Skin Peels/Resurfacing – Obagi® Blue Peel
The Obagi® Blue Peel is a TCA (trichloroacetic acid) peel. It removes thin surface layers of damaged skin. The damaged skin layers are replaced by healthier ones, allowing the skin's own clarity and tightness to resurface. It can be used on the face, chest, arms, back, and legs to improve skin quality. Peels are complementary to the Obagi® line of skin care, and available in my Palo Alto office, or as part of a larger surgical cosmetic procedure done in the outpatient operating suites in Palo Alto or Menlo Park. Skin products will help you heal faster from the peel.
To peel or not to peel? And what does that mean?
The peel I prefer is a 15 or 20 percent Obagi® TCA peel. This peel is stronger than those performed by a facialist, which is why it gives great improvement in wrinkling and pigmentation. It works like laser facial resurfacing, but I prefer it to laser. The peel is an in-office procedure; the downtime is reduced; it is safe on the neck and chest in addition to the face, so you have a blending of the results from the face onto the neck and chest.
Why would you want to do this?
Skin peels help resurface the skin. They are useful for patients with fine wrinkles, acne scarring, pigment irregularity, and sun damage. Many problems are located in the superficial to medium depth of the skin, such as shallow scars, large pores, fine and medium depth wrinkles, epidermal and dermal pigment problems, actinic Keats (pre-skin cancers), skin laxity, and acne. This will improve or rid your skin of those problems.
What about glycolic peels? Microdermabrasion? How is this different?
The TCA peel can go deeper. Anything that is a "lunchtime" peel will exfoliate by removing the epidermis (the topmost layer of skin). A TCA peel reaches deeper, going into the mid level of the dermis. The dermis is where the problems are, such as wrinkles and pigment, so it causes a real change in your skin.
What about laser resurfacing? How is this different?
Laser resurfacing is very similar in some ways to the peel: they both go to the dermal level to tighten skin and improve pigment problems. The difference is that lasers can make skin red for several months following the procedure. It is not safe for the neck or chest, and in time can detract from pigment in skin causing an unsightly difference in skin tones. Laser is not safe to do on medium to darker skin types.
The blue peel is the first chemical peel to successfully resurface a broad spectrum of skin types, including Asian, African American, Indian, and Latin skin types. (Lasers can cause skin lightening or hyperpigmentation in these patients.) The photos say it all! For more information, go to www.Obagi.com. To see my personal patient results, please schedule an office appointment.
SkinCeuticals
I am excited about this new line ( www.skinceuticals.com). It is based on antioxidant treatment, using Vitamin C and E and natural ingredients. It was created by doctors, so it has the highest levels of antioxidant protection. The line is a higher concentration than over-the-counter products. It is "bio-available" (which means that it actually penetrates the skin in a form your body can use, unlike many other products that have the vitamins in an ineffective form), and it has been stabilized so that it remains effective.
So why do I like it?
1. I think Obagi® with hydroquinone and Retin-A® is a gold standard for treating fine lines and pigment, BUT many people with fair or sensitive skin cannot tolerate the line.
2. This line is safe for women who are pregnant or breast feeding.
3. This line has been out for years, and there are solid scientific studies that support its claims.
4. Vitamins C and E help enhance the performance of sunscreen, to provide better protection against UVA and UVB rays than sunscreen alone, which is important to us in the Bay Area with our sun exposure. This is a fantastic new product line available in my office in Palo Alto.
Skin Cancer
Skin cancers are common. A plastic surgeon's role is to remove the cancer while trying to hide or minimize the scar. Skin cancer risk is higher in patients with fair skin and eyes, a long history of sun exposure (work outside, golf, tennis), and a family history of skin cancer. Again, skin cancer is common, and can be seen in patients as early as their 30s. Usually signs of sun damage precede the skin cancer. General signs of skin damage are: age spots, freckles, scaling patches, lesions that change in size, color, or shape, and lesions that won't heal.
About 85 percent of skin cancers occur on the head and neck. Living in California, we have a great deal of sun exposure. Sunscreen should be worn as part of our daily routine. And don't forget to protect your scalp with a hat. A proper skin care routine can help patients avoid this dangerous condition. Contact my Palo Alto practice for more skin care tips.
Types of Skin Cancer
Basal Cell Cancer
Basal cell cancers are usually flesh colored, raised, and occasionally have a central ulceration. They are the most benign of the skin cancers. They will grow locally, but rarely spread to lymph nodes and other areas of the body. They are cured through a simple excision done in the office under local anesthesia.
Squamous Cell Cancer
Squamous cell cancers are slightly more aggressive. They tend to be flesh colored and occasionally grow quickly. They are removed with a simple surgery as well. These cancers can be more aggressive, and can spread to the lymph nodes and other areas.
Melanoma
Melanomas are the most aggressive skin cancers. If you have a mole that is changing in color, has color irregularity (some of the lesion is brown, some is black), has an irregular border, or is larger in size than a pencil eraser, you need to have it evaluated. Those with more than 30 moles on their body or a family history should have regular visits with a dermatologist.
The prognosis of melanoma depends of the thickness of the mole. The thickness is not something seen from the skin surface. A full thickness skin biopsy is done and sent to pathology to determine thickness. Thick melanomas can spread through the body and can be lethal. When caught early, as an atypical mole or an "in situ" cancer, melanomas are curable.
To learn more about the skin care treatments I offer at my Palo Alto practice, contact my plastic surgery practice today. I can recommend the appropriate skin care solution to help you meet your individual goals and needs.