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Ulthera or Thermage?

Which is better Ulthera or Thermage….I have followed both technologies since their inception, Thermage for about the last 10 to 12 years, and Ultherapy by Ulthera for the past 4 years.  Based on the science behind them and the patient satisfaction results, Ultherapy by Ulthera is a superior treatment.

Ultherapy by Ulthera is the only FDA approved device for both tightening and lifting of the muscles and skin of the face and neck, including the eye brows.  Ultherapy is the only technology available that uses ultrasound to heat the muscles and skin to create both deep and superficial collagen production.  The level of the treatment is visualized on an ultrasound screen to insure that the energy is being delivered to the proper level.

The muscle fascia or SMAS is targeted in the neck and face.  This is the same layer that s surgeons tighten when they perform surgical face lifts.  Ulthera energy goes deeper than any other energy device, 4.5 mm for the SMAS, and 3.5 mm for the deep skin collagen production.  The patient satisfaction rate with Ulthera is about 90% in the clinical studies.

Thermage is a radio frequency technology device that heats the skin and subcutaneous tissue superficially.  Although Thermage has been improved over the years, it’s main problems have been a very high patient dissatisfaction rate (up to 66%), and a very painful patient experience.  Ulthera can cause discomfort as well, but if patients are enduring pain, they appreciate a result that they can notice.

Ultherapy, featured in Vogue, is a safe and effective non-invasive ultrasound (US) treatment that can lift and tighten facial skin and muscle without downtime.  According to Catherine Piercy, author of the well written Vogue article, “Ulthera…is making it much easier to imagine a world in which hooded lids, falling cheeks, and lazy jaw lines can be treated without a single incision”.

Originally FDA approved for lifting eyebrows non-surgically,Ulthera’s unique state of the art technology is now used to lift and tighten the face, neck, and other areas of the body.  It has successfully treated the lines along the upper lip that are most difficult to treat with injectables.

Ultherapy is performed in the office with only ultrasound gel applied to the skin.   An ultrasound screen image allows the technician  to visualize the level of treatment before US energy is applied to the targeted tissue.  The treatment takes from 45 to 90 minutes depending on the area(s) treated.  Cost also depends on the areas treated.

What about the discomfort level?  Again from Ms. Piercy in Vogue, “If anything, Ultherapy’s greatest drawback may be the pain factor, which ranges from a hot prickling sensation to short but intense bursts of discomfort”.  Patients can be given oral medications or local anesthetic nerve block injections if needed, but the majority of Ulthera patients are able to tolerate a properly performed treatment with a topical numbing cream.

Although many patients see immediate lifting results, the ultimate results do not happen overnight, but gradually over time.  It can take up to 2-3 months for optimal rejuvenation.   Ulthera has been used for close to 2 years.  Some patients treated 1 1/2  to 2 years ago are now returning for second treatments.  Though they still appear improved from their pre-treatment “before” photos, most desire further improvement, further turning back the hands of time.  Patients feel and notice the tightening to the point of being satisfied. After two years of personal research and due diligence about the clinical benefits of Ulthera, as well as being impressed by the findings and experience of worldwide  respected cosmetic physicians, I  decided to add Ulthera to our practice 2 years ago.  We have been overwhelmingly pleased with the results as have our patients.  As with all cosmetic treatments, results will vary depending on the skill,experience, and aesthetic sense of the treating physician, physician’s assistant, nurse, or staff member.  Results will also depend on proper diagnosis and patient selection.  Side effects may include some bruising, swelling, and a feeling of tightness in the days after the procedure.

Ultherapy by Ulthera has been recently featured  on Dr. Oz, The Doctors,as well as on Real Self reviews, links which you may access for further information about this amazing state of the art technology.

 

10 Benefits of Adding Coconut Oil to Your Diet

1. Coconut Oil Contains a Unique Combination of Fatty Acids With Powerful Medicinal Properties

Coconut oil has been demonized in the past because it contains saturated fat. In fact, coconut oil is one of the richest sources of saturated fats known to man, with almost 90% of the fatty acids in it being saturated.

However, new data is showing that saturated fats are harmless. Many massive studies that include hundreds of thousands of people prove that the whole “artery-clogging” idea was a myth.

Additionally, coconut oil doesn’t contain your average run-of-the-mill saturated fats like you would find in cheese or steak.

No, they contain Medium Chain Triglycerides (MCTs) – which are fatty acids of a medium length.

Most of the fatty acids in the diet are long-chain fatty acids, but the medium-chain fatty acids in coconut oil are metabolized differently.

They go straight to the liver from the digestive tract, where they are used as a quick source energy or turned into so-called ketone bodies, which can have therapeutic effects on brain disorders like epilepsy and Alzheimer’s.

2. Populations That Eat a LOT of Coconut Are Among The Healthiest People on The Planet

 

Coconut is kind of an “exotic” food in the Western world, primarily consumed by health conscious people.

However, in some parts of the world, coconut is a dietary staple that people have thrived on for many generations.

The best example of such a population is the

Tokelauans, which live in the South Pacific.

They eat over 60% of their calories from coconuts and are the biggest consumers of saturated fat in the world.

These people are in excellent health, with no evidence of heart disease.

Another example of a population that eats a lot of coconut and remains in excellent health is the Kitavans.

 

3. Coconut Oil Can Increase Your Energy Expenditure, Helping You Burn More Fat

 

Obesity is currently one of the biggest health problems in the world.

While some people think obesity is only a matter of calories, others (myself included) believe that the sources of those calories are critical too.

It is a fact that different foods affect our bodies and hormones in different ways. In this regard, a calorie is NOT a calorie.

The medium-chain triglycerides (MCTs) in coconut oil can increase energy expenditure compared to the same amount of calories from longer chain fats.

One study found that 15-30 grams of MCTs per day increased 24 hour energy expenditure by 5%, totalling about 120 calories per day.

 

4. The Lauric Acid in Coconut Oil Can Kill Bacteria, Viruses and Fungi, Helping to Stave Off Infections

 

Almost 50% of the fatty acids in coconut oil is the 12-carbon  Lauric Acid.  When coconut oil is enzymatically digested, it also forms a monoglyceride called monolaurin.

Both lauric acid and monolaurin can kill harmful pathogens like bacteria, viruses and fungi.

For example, these substances have been shown to kill the bacteria Staphylococcus Aureus (a very dangerous pathogen) and the yeast Candida Albicans, a common source of yeast infections in humans.

 

5. Coconut Oil Can Kill Your Hunger, Making You Eat Less Without Even Trying

 

One interesting feature of coconut oil is that it can reduce your hunger.

This may be related to the way the fatty acids in it are metabolized, because ketone bodies can have an appetite reducing effect.  In one study, varying amounts of medium and long chain triglycerides were fed to 6 healthy men.

The men eating the most MCTs ate 256 fewer calories per day, on average.

Another study in 14 healthy men discovered that those who ate the most MCTs at breakfast ate significantly fewer calories at lunch.

These studies were small and only done for a short period of time. If this effect were to persist over the long term, it could have a dramatic influence on body weight over a period of several years.

 

6. The Fatty Acids in Coconut Oil Are Turned into Ketones, Which Can Reduce Seizures

 

A so-called ketogenic (low carb, higher fat) diet is currrently being studied to treat various disorders.

The best known therapeutic application of this diet is treating drug-resistant epilepsy in children.

For some reason, this diet can dramatically reduce the rate of seizures in epileptic children, even those who haven’t had success with multiple different types of drugs.

Because the MCTs in coconut oil get shipped to the liver and turned into ketone bodies, they are often used in epileptic patients to induce ketosis while allowing for a bit more carbs in the diet.

 

7. Coconut Oil Can Improve Blood Cholesterol Levels and May Lower Your Risk of Heart Disease

 

Coconut oil is loaded with saturated fats, which actually do not harm the blood lipid profile like previously thought.

Saturated fats raise HDL (the good) cholesterol and change the LDL cholesterol to a benign subtype.

In one study in 40 women, coconut oil reduced Total and LDL cholesterol while increasing HDL compared to soybean oil.  Also improves blood coagulation factors and antioxidant status.

This improvement in cardiovascular risk factors should theoretically lead to a reduced risk of heart disease over the long term.

 

8. Coconut Oil Can Protect Hair Against Damage, Moisturize Skin and Function as Sunscreen

 

Coconut oil can serve various purposes that have nothing to do with eating it.

Many people are using it for cosmetic purposes and to improve the health and appearance of their skin and hair.

Studies on individuals with dry skin show that coconut oil can improve the moisture and lipid content of the skin.

Coconut oil can also be very protective against hair damage and one study shows effectiveness as sunscreen, blocking about 20% of the sun’s ultraviolet rays.

Another application is using it like mouthwash in a process called oil pulling, which can kill some of the harmful bacteria in the mouth, improve dental health and reduce bad breath.

 

9. The Fatty Acids in Coconut Oil Can Boost Brain Function in Alzheimer’s Patients

 

Alzheimer’s disease is the most common cause of dementia worldwide and occurs primarily in elderly individuals.

In Alzheimer’s patients there appears be reduced ability to use glucose for energy in certain parts of the brain.

Ketone bodies can supply energy for the brain and researchers have speculated that ketones can provide an alternative energy source for these malfunctioning cells and reduce symptoms of Alzheimer’s.

In one 2006 study, consumption of medium chain triglycerides led to immediate improvement in brain function in patients with milder forms of Alzheimer’s.

Other studies support these findings and medium chain triglycerides are being intensively studied as potential therapeutic agents in Alzheimer’s disease.

 

10. Coconut Oil Can Help You Lose Fat, Especially The Dangerous Fat in Your Abdominal Cavity

 

Given that coconut oil can reduce appetite and increase fat burning, it makes sense that it can also help you lose weight.

Coconut oil appears to be especially effective in reducing abdominal fat, which lodges in the abdominal cavity and around organs.

This is the most dangerous fat of all and is highly associated with many Western diseases.

Waist circumference is easily measured and is a great marker for the amount of fat in the abdominal cavity.

A study in 40 women with abdominal obesity, supplementing with 30 mL (1 ounce) of coconut oil per day lead to a significant reduction in both BMI and waist circumference in a period of 12 weeks.

Another study in 20 obese males noted a reduction in waist circumference of 2.86 cm (1.1 inches) after 4 weeks of 30 mL (1 ounce) of coconut oil per day.

This number may not seem too impressive on the surface, but be aware that these people aren’t adding exercise or restricting calories. They’re losing significant amounts of abdominal fat simply by adding coconut oil to their diet.

Smooth and Tight Body Skin

It’s important to always keep your skin in its best shape. Become a firm believer in younger looking skin with the Firm by Invasix, a new, advanced non-invasive treatment specifically designed to remodel the skin to fight the effects of gravity. This professional treatment provides contraction in the deep layers of the skin. During the treatment, new collagen formation is stimulated to improve and smooth the skin’s surface. It used on the face and neck, as well as body areas such as the knees, abdomen, thighs, and arms that might need contraction, BENEFITS OF FIRM:
Immediate results on the treatment table
Stimulates collagen production
Contracts collagen for a tightening sensation in the skin
Diminishes appearance of fine lines and wrinkles
Smoothes skin texture
Avoid more extensive surgery
Non-invasive with no downtime, feels like a pleasant, warm facial massage.

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Ulthera vs Botox

According to the BotoxCosmetic® website, close to 12 million people have had Botox® treatments since its release in the United States in 2002. Botox® has become standard treatment for forehead wrinkles and is the centerpiece of virtually every aesthetic practice’s cosmetic offering.
An interesting phenomenon accompanies aging where Botox® alone becomes less effective in reducing wrinkles and lines and frequently leads to a lowered brow position. Many feel they have become “immune” to Botox. ® They attribute brow lowering to their body “fighting” the cumulative effects of Botox® as it tries to elevate the brows.
Atrophy of facial bones and fat typically begins at age thirty. As the aging process progresses, atrophy of the frontal (forehead) bone is evident as there is less antigravity support for the forehead. The body responds with more forehead muscle activity to lift the falling forehead. This, along with thinning of the skin, results in more visible forehead wrinkles. Using more Botox® initially may be effective; however, wrinkles caused by increased muscle activity are critical to maintaining brow position. Therefore Botox® actually leads to a lowered or aged brow position.
The correct way of treating the aging process and forehead wrinkles is to treat the cause—forehead atrophy. Fillers work well but do not slow the aging process and can be expensive due to the large area of the forehead. Fat grafting works; the stems cells in body fat slow the aging process, but the procedure is quite technique dependent. Today, another alternative is available.
Ulthera ®has been used successfully to elevate the brow position by tightening the forehead skin and muscle. It also increases the collagen content of the skin improving elasticity and reducing wrinkles during animation. Using Botox® between the eyebrows and for crow’s feet releases these muscles resulting in additional brow elevation.
This combination approach has given patients a dynamic duo that treats both the symptom and the cause of aging in the upper third of the face, cost effectively and with no downtime.

Anatomy of the skin around the eyes

The anatomy of the skin around the eyes, also referred to as the adnexa is unique to the face and body. In order to properly care for the skin around the eyes, it is important to understand not only the anatomy of this area, but also the process of skin cell renewal.

Eyelid skin is composed of several layers. The deepest, the subcutaneous layer contains a thin layer of fascia which lies on top of the orbicularis muscle, a muscle that allows the eyelid to move. Next, the dermis, which forms the support layer of the skin, is made up of threadlike proteins including bundles of elastin and collagen, fibroblasts, nerves and vessels. The top layer, the epidermis, is made up of basal cells, melanocytes, Langerhans cells, keratinocytes and on top, the dead cell layer (also known as the stratum corneum) made up of corneocytes. The epidermal layer gives the skin its appearance, color, suppleness, texture, and health.
Basal cells reproduce new cells every few days. As these cells migrate upward, they become drier and flatter.  Once they reach the surface of the skin, they are no longer alive, and are referred to as corneocytes. This process of migration from basal cell to corneocytes is what gives the epidermis the ability to regenerate itself. This skin renewal process is known as desquamation. Desquamation is an ongoing process that takes about two seeks in a young person, and significantly longer – about 37 days for individuals over 50. The build up of corneocytes gives skin a callous or dry, aged and thickened look. The skin feels and looks rough and its ability to retain water becomes impaired.

Sexy lips

lip print

Augmentation of the lips should be subtle.  A small increase goes a long way and gives a natural, sexy fullness to the lips. Your lips should not arrive in a room before you.

You should discuss what you’d like your lips to look like. Do you want more body in your lips, more definition of the edges of the lips, or both? Your upper lip should be smaller than your lower lip (70% the size of the lower lip). The lower lip should not be filled all the way to the corner (oral commissure) to avoid a “sausage” appearance.

Juvederm® is an excellent material for lip augmentation. It is made out of hyaluronic acid, a substance that is found naturally in the intra- and extracellular matrices of our bodies. Juvederm® is derived through a synthetic process by Allergan, the maker of Botox®. Juvederm® provides and even volumetric enhancement (plumping) of the lips because it is hydrophilic (attracts water), which helps with the lines around the lips as well.