 Frequently Asked Questions
Botox
I am
curious to try Botox, but I am
concerned I will have an unnatural look. Do I
need to worry?
In expert hands, Botox can provide a subtle but
highly effective reduction in unwanted frown lines,
forehead lines, crow's feet and upper lip lines. It is
also possible to provide a nice eyebrow lift, a
reduction in down turning at the edges of the
mouth, a reduction in chin dimpling and a
reduction in neck lines.
We do not relax any facial muscles that affect
smiling or general expressivity.
The result is a softer, calmer and more youthful look. Overall patient satisfaction
with Botox is very high.
Isn't Botox a toxin? Will it affect the rest of my body?
Botox is slowly metabolized by the body and when precisely injected into
small muscles works only where injected. Botox has been used safely even in
children for over 20 years. Relatively small doses of Botox are used in cosmetic
treatments. There are no known long term effects.
Will I be swollen or red after a Botox treatment?
In most cases, no one will know you have had a treatment at all! Bruising can
occur but is uncommon and usually minor. We use ice to minimize both
discomfort and swelling, but most patients are amazed at how simple treatments
are. If there is any redness from the injection, we provide post-treatment touchup
makeup for all skin tones free of charge.
Are any of these so-called "muscle relaxer" creams, I see advertised
as effective as Botox in reducing wrinkles?
Next to a facelift or aggressive laser resurfacing, there is no better treatment
available today that can reduce certain lines and wrinkles faster, safer or more
effectively than Botox. Creams are unable to penetrate deeply enough to
significantly affect muscles. Any advertising claims suggesting this are simply
untrue.
Tissue Fillers
I've heard of facial fillers such as Perlane and Restylane. What are
they and will they help me?
There are many different filler materials available today. We prefer the Perlane
and Restylane products manufactured by Q-Med because the hyaluronic acid
used is nearly identical to that produced by our own bodies. Restylane and
Perlane are clear gels made up of non-animal source hyaluronic acid which is
produced via a culture process not unlike that used to manufacture vaccines.
Hyaluronic acid is a naturally occurring substance in the body that comprises
the fluid in joints and other tissues. There is a natural loss of hyaluronic acid as
we age. When injected, the products are naturally integrated into the tissues to
expand the crevices formed by wrinkles and folds. It also makes an ideal volume
expander for lip enhancement. Perlane and Restylane can be used alone or
combination with Botox to fill in lines and wrinkles that are deeper or more
permanent. Perlane and Restylane are ideal for reducing deep folds on the side
of the nose and mouth, upper lip lines, deeper lines between the eyebrows or for
cheek enhancement.
What about the so-called permanent fillers? Should I be considering
them?
Some products are marketed as permanent implants, but we do not
recommend them. They usually contain substances that are not natural to the
body and, hence, cannot be absorbed. We are concerned about the potential for
scarring, lumpiness or movement of the implant. We view tissue fillers as a
maintenance therapy, much as you would maintain your hair or teeth. Perlane
and Restylane offer the advantage of giving you a choice once the effects have
worn off.
Veins
I have spider veins all over my legs. Can I just have laser treatments
to clear them up?
Although laser can treat spider veins, they will often come back unless more
comprehensive treatments with sclerotherapy are performed first. Virtually, all
spider veins are being "fed" by larger veins that have leaking valves.
The golden rule of vein treatments is to always treat the larger, leaking veins first
before attempting to remove the smaller spider veins, otherwise, recurrence rates
are high. Lasers can only treat small vessels less than 3 mm in diameter. The
"gold standard" treatment today is to close feeding veins with injection
sclerotherapy before attempting to treat the spiders.
Okay, so what is sclerotherapy and how many treatments will I need?
Sclerotherapy can be divided into two categories: a. Ultrasound-guided
sclerotherapy for the treatment of larger, deeper veins b. Surface sclerotherapy to
treat medium to small and even spider veins.
Sclerotherapy involves injecting a sclerosant solution into the offending vein
which then inflames the vein and then ultimately shrinks the vein to the point
where it is re-absorbed by the body. A series of treatments are necessary to
remove all veins and the number will depend on the severity of the vein disease.
Anywhere from two to ten treatments may be necessary. Sclerotherapy is highly
effective, virtually painless and very safe.
Is the sclerosing solution used to treat varicose veins safe?
The sclerosing solution used in our practice is called STS (sodium
tetradecylsulfate) which has been in use for over 50 years. STS has an admirable
safety record and has been used in hundreds of thousands of patients worldwide.
STS is a mild detergent which acts to irritate the inner wall of the vein ultimately
causing it to collapse. STS is both highly effective and remarkably safe.
What causes varicose and/or spider veins and how do I prevent them?
Varicose and spider veins are the result of increased pressure in the venous system. Small valves inside the veins that normally direct the flow of blood back to the heart may become floppy or incompetent causing a backwards flow of blood and a build up of pressure. The most common cause is heredity but pregnancy and possibly prolonged standing may also predispose individuals who have a genetic tendency to varicose and spider veins. Abnormal veins can be eliminated allowing normal veins to assume the roll of transporting blood effectively. No treatment is a guaranteed cure as new varicose or spider veins may occur in the future.
Cosmeceuticals
What are cosmeceuticals?
These are medical grade skin care products developed for physicians that provide pharmaceutical grade ingredients products and quality control. They have a proven
record of cleansing, moisturizing, protecting and exfoliating the skin to reduce
fine lines, restore glow and tone, protect against the harmful effects of solar
radiation and pollution and generally slow the effects of aging on the skin. They
contain higher concentrations of antioxidants, retinoids, alphahydroxy acids and
other proven medical therapies in skin care. At Sanders Medical, we seek out
only the highest-quality skin care products for our patients.
Sun-Damaged Skin
What is sun-damaged skin and what can I do about it?
Sun damage occurs to the skin over time primarily from the effects of solar
ultraviolet radiation. Radiation damage degrades the collagen or protein deep in
our skin. This leads to loosening of the skin and sagging as well as
discolouration through pigment changes and the development of fine capillaries.
There are a number of treatments available for sun damaged skin including
cosmeceuticals, photodynamic therapy, microdermabrasion, Botox, Restylane
and Intense Pulsed Light. Intense Pulse Light is particularly effective in the
treatment of sun damaged skin, as it can stimulate the collagen, reduce the
age-related pigmentation and capillary changes and improve overall skin tone.
Our cosmeceutical skin care products are formulated to help reduce
photodamage and to protect the skin during sun exposure from further damage.
Acne
What is photodynamic therapy and how does it work?
Photodynamic therapy refers to the use of a medication called Levulan (20%
aminolevulinic acid) which is applied as a clear liquid to the face. It is allowed to
incubate for a given period of time and then it is "photoactivated" using
specific
wave lengths of light. The photoactivate Levulan then kills off rapidly-growing cells
such as actinic keratoses (precancers) on the skin. It also acts to kill bacteria
and reduces the size of oil glands and, therefore, has proven to be very effective
in the treatment of acne as well. We activate the Levulan using a special Blue
light but Levulan can also be activated using Intense Pulsed Light to provide an
additional benefit in terms of reducing brown age spots and capillaries.
I don't like taking pills such as antibiotics or Accutane for my acne.
How comparable are the benefits of photodynamic therapy?
Photodynamic therapy with Levulan has proven itself to be at least, if not more
effective, than topical and antibiotic therapies for acne. In some cases, acne
treatments with photodynamic therapy have been comparable to Accutane
without any of the side effects and potential toxicities associated with Accutane.
A series of treatments, usually between two and four spaced two to three weeks
a part have been shown to be a highly effective alternative treatment for acne.
Does anything cure acne?
There is no known cure for acne. Managing acne means keeping it under control. Accutane in some instances does provide for a prolonged remission but recurrences are common no matter what therapy is used and this applies to photodynamic therapy as well.
Laser Hair Removal
How does laser hair removal work? Does it hurt? How many
treatments will I need?
Laser hair removal is a modern alternative to older methods of hair removal
such as waxing, plucking and electrolysis. Laser hair removal works because the
specific wave length of light in the laser targets and destroys the pigment in the
hair follicle. The laser targets only those hairs currently in their growth phase
and, therefore, a number of treatments are necessary since only about 20% to
30% of hairs are growing at any given time on the body. The number of
treatments will vary from three to six or more depending on the colour of your
skin, the thickness of the hair, the colour of the hair and the location on the
body. For most patients, laser hair removal is essentially painless and highly
effective.
Is laser hair removal permanent?
Lasers that target the hair follicle pigment can eliminate the follicle. Sometimes the hair is just stunned and will regrow. Often the hair that grows back is finer than the original hair. Although repeat treatments will give the best results there is a point where further treatments will not result in further hair removal. It is important for the laser hair removal patient to receive a careful evaluation by a clinician experienced in laser hair procedures.
Are laser hair removal treatments safe?
In experienced hands laser hair treatments are safe. Tanned skin should never be treated no matter what the claims of the laser provider are regarding their particular laser device. Lasers target the pigment in skin. If a tan is present, the laser hair treatment will be compromised and at best the patient will receive an inferior treatment and at worst a nasty burn could result. Because lasers are serious medical devices that can have adverse effects including skin burns, they should only be used in medical offices, operated by clinicians under medical supervision.
Intense Pulsed Light (IPL) Photofacials
What exactly is a photo facial?
A photo facial refers to a treatment with Intense Pulsed Light (IPL) to reduce
many of the hallmarks of sun damage and aging. It works like a laser to safely
penetrate through the skin to deeper structures without harming the skin itself.
The light works to shrink small capillaries that cause flushing and unwanted
redness. It also breaks up age spots and other pigmented lesions which are the
result of progressive photo damage. IPL also stimulates the collagen, a protein in
the dermis, to improve overall skin tone and texture. It reduces pore size and
diminishes fine lines. IPL is also used to treat sun damage on hands, arms,
neck, shoulders and the back. IPL therapy is one of the most popular
non-surgical cosmetic procedures in North America for men and women.
Are all IPL devices the same?
There are many different IPL devices on the market. Some spa-grade IPL devices are under-powered and can’t perform as promised. Not all IPL devices work equally at eliminating capillaries and brown spots. The makers of the Lumenis Vasculight invented IPL technology and their IPL devices remain among the best on the market today. Our Lumenis Vasculight Elite is a superior IPL device providing excellent results and patient satisfaction.
Thermage
What is Thermage and will it work for me?
Thermage uses radiofrequency (RF) energy to heat the deeper layers of the skin and the collagen protein that resides there to induce collagen contraction. Patients who have adequate collagen to begin with i.e. usually patients between the ages of 35-60 will get the best results though we have seen good tightening with older patients as well. The important point to remember with Thermage is that the results are fairly subtle. Whereas a surgical face lift will achieve better overall results, it often does alter the intrinsic appearance of the patient. Poor outcomes and complications such as infection and scarring are very real risks of any surgical procedure. Thermage will not alter a person’s appearance but rather produce subtle but usually very satisfactory skin tightening without the recovery time or risks associated with surgery. If you would be happy with a mild improvement and want a treatment without any significant recovery time, then Thermage might be a good treatment for you.
Microlaser Peel
Who is the best candidate for a Microlaser Peel (MLP)?
People with lighter skin tones who have fine lines, brown pigmentation or who are looking to refresh their skin make good MLP candidates. Most patients will experience some improvement in their overall skin tone and complexion with the MLP but an assessment by one of our physicians prior to treatment is essential to determine if you are a good candidate. There is recovery time associated with this treatment so don’t consider a MLP if you are not prepared to be good and red for 3-5 days.
Surgical vs. Non-surgical Procedures
What are non-surgical cosmetics procedures?
These are procedures that do not require incisions, general anesthetic or
healing time. They are usually painless, have little or no recovery time and are
generally not associated with significant complications such as scarring or
infection.
Do I need to see a plastic surgeon for a cosmetic procedure?
You need to see a surgeon only if an operation is required. Non-surgical
procedures such as Botox or Restylane injections are best performed by
physicians with expertise in injection techniques who have a keen eye for artistic
facial symmetry and who are passionate and committed to their work. Laser and
IPL therapies can theoretically be provided by non-physicians but they, of
course, will not be qualified to properly medically assess your skin. It is best to
seek a clinic run by physicians that has the best available equipment and well
trained and dedicated staff.
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