Dr. Lori L. Greenwald of Vanishing Veins & The Aesthetic Center

Skin Rejuvenation

As we age our skin accumulates damage from the sun, the elements and the wear-and-tear of daily life. Skin Rejuvenation can repair signs of aging and "turn back the clock" by removing age spots, most brown pigmentation and redness due to broken capillaries. Thus, it improves the appearance of rosacea, flushing and sun damaged skin while improving skin texture and a dull complexion. The treatment also improves mild acne scars, reduces large pores, corrects dark circles around the eyes, and reduces fine lines.

At Vanishing Veins we use the HarmonyXL system from Alma Lasers, utilizing Advanced Fluorescence Technology (AFT™). It employs an advanced algorithm that stabilizes each pulse to ensure predictable, reproducible treatments that are safe and effective. An intense light is produced that is applied in a series of gentle pulses over the treatment area. The light penetrates the skin and is absorbed by and heats the pigmentation and/or abnormally dilated vessels, causing remarkably little or no skin damage. Clinical trials conducted by leading authorities on pulsed light document its safety and effectiveness. Though there may be some discomfort, generally described as a rubber band snap, a cooling device is used to minimize the soreness.

Treatment may vary from 15 to 45 minutes and involves little to no downtime. Patients generally require a minimum of four treatments to achieve the desired effect; some patients require more. At the time of your treatment the area is first cleansed and a cool gel is applied. The light pulse is then delivered with little or no discomfort. After treatment, the gel is removed and the skin is cleansed. You can resume all regular activities immediately. Immediately following treatment the skin may appear flushed, brown pigmented spots may appear darker and capillaries may be more visible. To help guarantee the best results, limit your exposure to the sun for several weeks before and after treatment. After an initial course of therapy follow-up treatments may be desired once a year to maintain results.

Pulsed Light Treatment of Facial Veins/Lesions

As one ages a variety of pigmented or vascular abnormalities can accumulate on the face. These unsightly lesions include broken capillaries on the nose and cheeks, medium and smaller vessels on other facial areas, hemangiomas, port wine stains, rosacea and poikiloderma. All of these can be treated with pulsed light, which can be applied to small facial areas or the entire face.

At Vanishing Veins we use the HarmonyXL system from Alma Lasers, utilizing Advanced Fluorescence Technology (AFT™). It employs an advanced algorithm that stabilizes each pulse to ensure predictable, reproducible treatments that are safe and effective. An intense light is produced that is applied in a series of gentle pulses over the treatment area. The light penetrates the skin and is absorbed by and heats the pigmentation and/or abnormally dilated vessels, causing remarkably little or no skin damage.

In the case of vascular lesions the heat causes the vessel to close off. With pigmented lesions, the light energy heats the melanin in the lesion and causes it to fragment. The melanin fragments are then absorbed by the body and eliminated. Clinical trials conducted by leading authorities on pulsed light document its safety and effectiveness. Though there may be some discomfort, generally described as a rubber band snap, a cooling device is used to minimize the soreness.

A full-face treatment typically lasts anywhere from 20 to 40 minutes. Smaller areas, such as the nose, can be treated in 15 minutes. For best results repeated treatments are often required. Before treatment a cold gel is usually applied to the area to be treated. Then precise pulses of light are applied to the target area. Patients report little or no pain with AFT treatment and can return to their normal activities immediately.

Laser Hair Removal

Laser treatment for unwanted hair is a non-invasive approach to long lasting hair removal and reduction. A beam of highly concentrated laser light penetrates the skin and, without damaging the surrounding tissue, is absorbed by the hair follicles. The heat inhibits and ultimately destroys the potential for hair regrowth. At Vanishing Veins we use the newest and most revolutionary advance in hair removal which, as of 2008, is not otherwise available in the Hartford area - the SopranoXL with IN-Motion™ technology. It is truly safe and effective for all skin types. Since the laser is in constant motion, a much wider area can be treated more quickly and easily than was previously possible. The procedure is virtually pain-free due to its DualChill mechanism and the Zimmer cooling system that we use at Vanishing Veins. Thus, sensitive areas can easily be treated without the discomfort caused by other systems.

Preliminary setup requires cleansing and shaving of the area to be treated. Post-treatment the treated area is cleansed and sun block is applied. Large areas such as backs, shoulders, abdomens, and legs can be treated rapidly. Facial areas such as the lip, chin, and beard can be treated in minutes. Laser Hair Removal requires no downtime, meaning that you are free to resume regular activities immediately. For best results repeated treatments are generally required.

The advantages of hair removal at Vanishing Veins are:

Virtually pain free with no analgesics or other pre-treatments
Long-lasting
Quick – treatment for most patients is less than one hour
Recovery-free, so you can return to normal activities immediately
Effective for all skin types as well as different hair types
More complete coverage
Perfect for any area of the body - including more sensitive areas like the face, neck and bikini area

Botox®

Botox® is probably the best known cosmetic treatment in America. It is used in aesthetics to minimize facial wrinkles and lines, thereby erasing the most obvious signs of aging. It works well by itself but its effects are even more dramatic when used as part of a full program of skin and facial treatments. When you come to Vanishing Veins our staff will devise a personalized plan that will allow you to obtain the appearance that you aspire to.

Botox® has been used to minimize wrinkles since 1990. On top of that long record is the fact that this medication has been used since the 1980s for other more serious medical conditions with virtually 100 percent safety. This record of safety is the reason that in 2002 the FDA approved the use of Botox® Cosmetic for cosmetically treating the glabellar region (furrows above nose, between eyes). Though only formally approved for treatment in this part of the face, FDA regulations allow for treatment of wrinkles in other areas. Almost 3.3 million Botox® procedures were performed in 2005 and it is used for at least 20 different clinical indications in over 75 countries.

Why do we get wrinkles and what does Botox® do?
The lines and wrinkles that appear on your face result from muscle movement and the passage of time. When you smile or laugh folds transiently appear in your skin. Similarly, if you're angry or annoyed you knit your brows together. Underneath your skin your facial muscles contract, causing the overlying skin to pleat or fold. After repeating these movements innumerable times over the years these lines become imprinted in your skin and wrinkles are formed. For women, whose faces tend to be more animated than men's, and whose skin is typically more delicate, these lines may appear exaggerated and more permanent. Botox® works by temporarily relaxing the muscles involved in the development of these wrinkles. In this manner it smoothes the skin and gives a more youthful appearance.

The Botox® Injection procedure
When you come to Vanishing Veins we decide where to administer the Botox® injections by examining your ability to move certain muscles of your face. Several tiny injections of Botox® are then made in these spots. The entire BOTOX® injection procedure takes approximately 20 to 30 minutes and causes minimal discomfort.

After the procedure there's no recovery time needed. You can resume your normal activities. The most common side effects following injection include temporary eyelid droop and nausea. Localized pain, infection, inflammation, tenderness, swelling, redness, and/or bleeding/bruising may be associated with the injection. Patients with certain neuromuscular disorders may be at increased risk of serious side effects.

After the Procedure
Within five to seven days you will notice an improvement in frown lines and wrinkles in the treated areas. Improvement may continue for up to two or three weeks following the injections. There is no downtime and you can resume your normal activities. The duration of results varies but improvement may last up to four months. It is important that you understand that repeat treatments will be necessary. Otherwise, the muscle relaxing effects of Botox® will wear off and your wrinkles and frown lines will return to the state that they were in prior to treatment.

Dermal Fillers - Restylane®

Restylane® is one of a number of so-called dermal fillers. These are medications that are injected into the face in areas where wrinkles are present and are also injected in the lip to give a fuller look. They fill up these areas, make them plumper and flatten out wrinkles, giving a smoother and more youthful appearance. This is a completely different mechanism than that of Botox® which works by relaxing muscles that cause wrinkling. Restylane® was approved in 2003 by the FDA for lip augmentation. Though only formally approved for this purpose, FDA regulations allow for off-label treatment of other areas. Restylane works well in conjunction with several of the other advanced therapies that are available at Vanishing Veins. During your initial consultation we will develop a customized treatment plan that will address the problems that concern you.

What exactly is Restylane® and is it safe?
Restylane® is the first cosmetic dermal filler made of non-animal-based hyaluronic acid. Hyaluronic acid is a natural substance that already exists in the human body and is used to provide volume and fullness to the skin. The hyaluronic acid in Restylane® is a crystal-clear gel called NASHA or Non-Animal Stabilized Hyaluronic Acid. NASHA is biodegradable and fully biocompatible with human hyaluronic acid. Unlike rooster-derived hyaluronic acid-based products, Restylane® is free from animal proteins. This quality limits the risk of animal-based disease transmission or allergic reaction. Restylane® contains trace amounts of gram-positive bacterial proteins and should not be used by patients with a history of allergies to such material. If you are pregnant, breastfeeding or under 18 you shouldn't use Restylane®. Restylane has been used for over 4 million treatments worldwide with an excellent safety record.

The Restylane® Injection Procedure
When you come to Vanishing Veins we will review in detail the areas that concern you. After deciding on the appropriate sites for treatment the area will be anesthetized. We will then inject the Restylane into the chosen location with an ultra-fine needle. This procedure causes minimal discomfort. The results are immediate and you can resume your normal activities with no downtime. However, there may be some redness or swelling after treatment. This will normally last less than seven days. Sunbathing and cold outdoor activities should be avoided until any redness or swelling disappears.

How long does the effect last?
Though responses vary from patient to patient, in general Restylane® injections last for six months. It is important that you understand that repeat treatments will be necessary. Otherwise, the biodegradable material that is used will be slowly absorbed and your appearance will return to its pretreatment state.

Microdermabrasion with SilkPeel™ and Dermalinfusion™

At Vanishing Veins for microdermabrasion we use the SilkPeel™ technology with Dermalinfusion™, the most advanced system presently available. Similar to traditional microdermabrasion this system provides non-invasive exfoliation. However, in addition it delivers patient-specific solutions directly into the skin. All of this is performed without the use of crystals or other chemical exfoliants. As the procedure involves no down-time and does not leave you with inflamed or irritated skin it is an excellent treatment for the busy world that we all live in.

During the procedure the skin is "sanded" or "polished". From a medical perspective this means that the stratum corneum (the dead outermost layer of the skin) is partially or completely removed by light abrasion. Many facilities use crystals for microdermabrasion, essentially blasting these particles against the skin. However, crystal technology causes dust to be formed, which can be irritating, and there are some concerns about the long term safety of this treatment. For these reasons at Vanishing Veins we have chosen the SilkPeel™ system. This technology uses a diamond wand for microdermabrasion and obviates the need for crystals. The abraded skin cells are vacuumed away from the skin. This process enhances cellular turnover leaving your skin appearing visibly fresher.

However, the SilkPeel™ technology offers more than standard microdermabrasion treatments. Dermalinfusion™ infuses one or more of a variety of specialized treatment sera deep into the skin where they are maximally effective. These sera include vitamins, antioxidants and other therapeutic ingredients that brighten, clarify and hydrate your skin. This deep delivery system differs dramatically from the use of lotions or creams that simply sit on top of your skin.

The results of these treatments do not last forever and repeat treatments are usually required to maintain results. Additionally, SilkPeel™ can be most effective when combined with other treatments that we offer. During your consultation at Vanishing Veins our staff will devise a cutting edge and customized treatment plan that will make you look the best that you can.

Chemical Peels
There are a variety of conditions, including aging, in which injury to your skin occurs over time. When you are young the skin has a truly remarkable ability to regenerate and maintain a smooth and youthful appearance. However, over time this ability decreases and layers of injured skin accumulate. Since the time of the Pharaohs in Egypt people have known that the skin's appearance can be improved by applying a variety of substances that cause the topmost layer or layers to shed. This process stimulates the underlying layers of the skin, including the collagen, to regenerate at a faster rate and to normalize and improve appearance. Over the course of centuries, even millennia, this art has been refined and has led to the modern techniques of chemical peels.

Chemical peels can be used to improve a large variety of skin problems including:

fine lines and wrinkles
hyperpigmentation (skin discoloration or age spots)
enlarged pores
light freckling
mild scarring
acne and acne scarring
rough, dry skin
sun-damaged skin

Though chemical peels are most commonly applied to the face, they can be used on the arms, legs, neck, chest, and hands.

It is important to realize that peels are not generally effective for treating deeper wrinkles and sagging skin. It is also important to realize that these peels often work well in conjunction with several of the other advanced therapies that are available at Vanishing Veins. During your initial consultation we will develop a customized treatment plan that will address the problems that concern you and determine whether peels are right for you. Lastly, it may be necessary to undergo multiple peels in order to achieve the desired effect and, as with many aesthetic procedures, the results are not permanent and retreatment in the future may be necessary.

Depending on the solution used chemical peels range from so-called light or lunchtime peels to much more aggressive techniques. At Vanishing Veins we use light to medium strength peels. The formulation of a peeling regimen is extremely individualized and it is not possible to say without a consultation exactly which solution is right for you. Suffice it to say that a wide variety of ingredients are used in our peels. The aim of some of these ingredients is to cause the peeling effect while other ingredients are applied on a case-by-case basis as treatment for specific skin problems. In general, these lighter peels do not cause serious discomfort. The lighter peels cause little downtime, though sometimes, in consultation with the patient, a stronger peel may be used.

A few weeks before your procedure, we may recommend that you use specific pretreatment skincare products to prepare the outer layer of skin for treatment as well as to allow the chemical peel solution to soak evenly through your skin.

At the time of the procedure the treatment areas will be cleansed. While you may feel a slight stinging or warming sensation during the procedure, you will most likely not feel any significant pain. Therefore, an anesthetic is not necessary for a superficial peel. Using a sponge or a brush, the chemical solution is applied to the face. The solution will penetrate into your skin for up to fifteen minutes. Some solutions need to be neutralized with a different substance while other peels do not require this step. Other non-peeling but beneficial ingredients may also be applied to your skin. We will give you a specific post-peel regimen to use at home. It is most important that you follow our at-home directions exactly.

Again, depending on the solution used the side effects after the procedure may be quite minimal. However, after stronger peels you may experience redness and irritation that is similar to sunburn. In these cases as healing takes place you may also notice some crusting or flaking of your skin. These symptoms will most likely subside in approximately seven days. If you develop a true peel then you will most likely notice the outer layers of the skin peeling away within several days following treatment. New skin will begin to appear in approximately one to two weeks. IT IS ABSOLUTELY ESSENTIAL THAT AFTER THE PEEL YOU USE THE POST PEEL SKIN CARE REGIMEN THAT WE WILL GIVE YOU. IF NOT, YOU MAY EXPERIENCE WORSE RESULTS AND HAVE MORE PROBLEMS THAN IF YOU DO NOT FOLLOW OUR DIRECTIONS.

As stated before, superficial peels are a safe and effective form of skin rejuvenation. Again, these peels are frequently best used as part of a full customized plan of skin improvement, which we will devise with you when you come to Vanishing Veins.