April Undereye Special

There are lots of restrictions that doctors recommend when you are pregnant or breastfeeding. This is, in theory, to minimize as much as possible any risk to the baby. The fact is that there are no research studies performed on pregnant women. 

Why do we avoid some drugs and activities during Pregnancy?

Some risks are known well, and the recommendations come from a long history of experience. For example, there are many infections that are simple to treat in most adults which become deadly or damaging to the fetus if they happen when you are pregnant. For example– toxoplasmosis, a disease you can get from cat feces, shows up as a cold in most adults but can cause brain and liver damage in a fetus, as well as other bad effects. That’s why you can’t scoop the cat litter when pregnant!

But there are lots of things we also recommend you stay away from because we just don’t know what could happen. There have been no studies, so we just don’t know. Since it would be unethical to set up such a trial, we will likely never know. That’s why we recommend you stay away from most medications during pregnancy, unless they are absolutely necessary.

Is Botox off-limits during Pregnancy?

We do not recommend that you get Botox, Dysport or any neurotoxin treatment while pregnant or breastfeeding. Although we suspect the risk is low, we are simply not going to take that risk. Botox and Dysport are both shown to be taken up into the neuromuscular junction within 6 minutes of injections. The effect takes about 3-5 days for Dysport and 7-14 days for Botox. Neither has ever been shown to reach the bloodstream in any significant way when used in the proper doses for cosmetic use. This is why we do not see systemic effects when we treat wrinkles in the face. Despite this, we do not recommend taking that chance. 

Can you pump and dump Botox?

When breastfeeding, there is a concept of “Pump and Dump” when certain medicines or procedures are medically necessary. If you are breastfeeding, oftentimes a medicine is passed into your bloodstream, and could be secreted into your breast milk. If that is the case, the baby could be exposed by feeding on the breast milk. If a medicine is necessary, doctors will recommend that you use a breast pump to pump the milk and dump it, usually for 24 hours, to get it out of your system and not pass it along to the baby. This is called “Pump and Dump.” 

Could you get Botox or Dysport and Pump and Dump for 24 hours? You could, but in general this is not recommended, since Botox or Dysport is always considered an elective procedure, and is not medically necessary. Doctors recommend using this technique only when medically necessary.

What happens if you are getting Botox and then get pregnant?

If you are receiving Botox or Dysport injections and then find out you are pregnant, we recommend that you immediately stop getting injections. As stated above, though the risk is low, there are no studies, and we consider any risk simply too much. 

Should I stop Botox while trying to conceive?

Because the most critical part of development of a fetus is in the first trimester, early pregnancy is considered the most vulnerable time of the pregnancy. We recommend that you stop Botox treatments before trying to conceive. This means that the best timing is during or right after your period has ended, long before the next ovulation. Because women sometimes can have some bleeding in the very beginning of pregnancy, sometimes this can look like a regular period. So if there is any possibility that you are pregnant, we recommend that you defer any Botox treatments.

Can I get Botox for migraines when I’m pregnant?

In general, Botox is a Category C drug, and you should avoid using it during pregnancy because studies have not been done to establish that it is safe. However, studies of migraine patients have shown that people who have been treated with Botox for migraines while pregnant have no increased risk of birth defects. If migraines are severe and Botox is necessary, it has been used in patients who are pregnant. However, it is important to keep in mind that it should be completely stopped for any elective procedure.

What are some Pregnancy-Safe Botox alternatives?


Facials & Hydrafacial

Facials and Hydrafacials can temporarily smooth skin while you’re pregnant. Light chemical peels can help smooth fine lines and improve the texture and tone of the skin. Facials can be a great part of any skin care routine. Hydrafacial even has boosters that can provide other anti-aging ingredients to your skin.

Dermaplaning & Microdermabrasion

Exfoliation treatments such as dermaplaning and microdermabrasion are safe during pregnancy, and can remove dead cells, revealing fresh new cells at the surface. This improves the skin tone, helping reduce pigment.

Topical skin care

Most skin care products are completely safe during pregnancy. The ingredients to avoid are retinols, prescription tretinoin and hydroquinone. Most routine skin care products are safe, including 

  • AHA and BHA acids like glycolic and salicylic acid. 
  • Hyaluronic Acid (HA) products hydrate the skin, plump your epidermis and make your skin soft and smooth
  • Azelaic acid is often used to treat acne and hyperpigmentation
  • Benzoyl peroxide for acne

When is it safe to resume Botox after pregnancy?

If you are not breastfeeding, you can resume after childbirth. If you are breastfeeding, we recommend that you wait to resume Botox treatments until completely done. Although the risks are low, we have a zero risk policy when it comes to the safety of your newborn. This goes for other products and procedures that are off-limits during pregnancy as well.


Does getting Botox or Filler affect fertility?

Cosmetic injectables do not affect fertility. If you have had Botox, Dysport or filler in the past, it will not hurt the chances of getting pregnant. But we do recommend refraining from injectable treatments once you decide to start trying to conceive.


Summary:

  • If you find out you are pregnant or are trying to conceive, stop Botox and other cosmetic injectables right away
  • Some procedures are safe during pregnancy, like hydrafacial and peels
  • Though some ingredients must be avoided, such as retinols and hydroquinone, most skin care regimens are safe during pregnancy.

Rosacea is a common skin condition that causes redness and irritation of the skin. Many people have no idea that they have it, as it goes undiagnosed frequently. With proper skin care, redness and rosacea can be minimized. It is estimated that rosacea affects more than 14 million people in the United States alone. If you have rosacea or think you might have it, there are great skin care options available that can help.

What are the symptoms of Rosacea?

People with Rosacea experience some and sometimes all of the following symptoms:

  • Redness
  • Dilated blood vessels on the cheeks and around the nose
  • Easy flushing of the skin
  • Red acne-like bumps
  • Burning and stinging of the skin
  • Red swollen eyelids

What triggers Rosacea?

There are lots of things that can trigger symptoms of rosacea. Not everyone has them, but many do. If you can identify your triggers, avoiding them can help minimize the disease.

  • Sun exposure
  • Heat exposure (saunas, steam rooms)
  • Exercise
  • Friction (scrubbing with abrasive washcloths, sponges or brushes, microdermabrasion)
  • Chemical Peels
  • Skin Care products with acids, botanicals, fruit extracts, alcohols and some sunscreens
  • Fragrances in skin care products, laundry detergent, shampoo

What products should I avoid if I have Rosacea?

It is important to avoid skin care ingredients that make redness worse. These include:

  • Alpha- and beta-hydroxy acids (like glycolic, lactic and salicylic acid)
  • Products with fragrances
  • Botanicals
  • Menthol, alcohols and urea
  • Fruit extracts
  • Chemical sunscreens
  • Vitamin C (can often potentiate redness)
  • Retinols and Tretinoin
  • Sodium laurel sulfate (often found in shampoos and toothpaste)

What products are recommended if I have rosacea?

It is possible to use great anti-aging products and decrease redness and other symptoms of rosacea and at the same time stimulate collagen and improve the appearance of your skin. 

  • Gentle cleansers– a high-quality medical grade gentle cleanser – we recommend Sente’s Daily Soothing Cleanser– it is gentle and cleans the skin without irritation
  • Serums with anti-oxidants
  • Serums that minimize redness: Sente Dermal Repair Cream and Hydrafirm serum both have been shown in studies to decrease redness as well as supporting anti-aging goals like stimulating collagen. 
  • Platelet-Derived Exosomes: there is a new product developed out of the Mayo Clinic called [plated] that contains exosomes from platelets– these are little packets of stimulatory factors and growth factors that can stimulate collagen production, healing and decrease redness. Though these are on the pricey side, they have proven to be highly effective for both healing and anti-aging. 
  • Soothing and Calming moisturizers– ones that include ceramides and anti-oxidants and lack the usual irritating ingredients like retinols and acids.
  • High-quality medical-grade physical sun blocks. We recommend EltaMD sun blocks– they are high-quality, medical grade, fragrance-free and will not make you break out!

Top Rosacea Tips:

  1. Use the redness-decreasing products recommended above
  2. Avoid redness-inducing products listed above
  3. Test products on your skin before using them on your face: for any new product, test it out on your skin somewhere you don’t get rosacea, but nearby like on your neck. Use a small amount and wait 2-3 days. Sometimes skin reactions can be delayed. If your skin tolerates it well, go ahead and use it on your face.
  4. Wear sun block 365 days/year! Of course we recommend this for everyone for anti-aging, because the sun accounts for so much of the aging your skin experiences. But this will also decrease the sun’s effect on your rosacea.
  5. Use a gentle moisturizer twice each day. 
  6. Avoid abrasives and physical exfoliating and anything that requires friction– be gentle to your skin!

Do I need a prescription for my rosacea?

If you follow the steps described in this article, often you can keep rosacea at bay without any prescription medicines. There are many prescription topicals that are FDA-approved for the treatment of rosacea. If rosacea is a problem despite great skin care, these can be used to decrease the redness and appearance of dilated vessels and acne rosacea.

The most common topical prescriptions for rosacea are generally used for the bumps and pimples associated with moderate to severe rosacea:

  • Metronidazole
  • Azelaic Acid
  • Ivermectin

Sometimes, your doctor will prescribe oral doxycycline, an antibiotic that also has anti-inflammatory properties. This is often prescribed for ocular rosacea (seen inside the eyelid).

Can lasers treat redness and rosacea?

Intense Pulsed Light (IPL)

One very effective treatment for rosacea is Intense Pulsed Light (IPL) or Broadband Light (Sciton’s BBL). IPL/BBL is an energy device that is similar to a laser. While lasers use a single wavelength of light, IPL and BBL use a band of light wavelengths. The treatment is well-tolerated without any topical anesthetic, with minimal discomfort. The skin is immediately quite red, but this fades over the next few hours. The baseline redness of the skin, along with dilated vessels and red spots then fade over the next 1-2 weeks. Often a series of treatments is needed to maximize the effectiveness of the IPL or BBL procedure. We often recommend a series of 3, about a month apart, but this can vary.

“Red” Lasers

There are several different types of lasers that can also be used to treat redness. Often a Pulsed Dye laser (Candela’s Vbeam) or KTP laser is used for red lesions on the skin. These are both lasers that have wavelengths that are able to target the red color of the lesion. These lasers tend to be more expensive than IPL, and are usually found in dermatology offices. 

Can diet help with Rosacea?

Because Rosacea is a chronic inflammatory disease, consuming an anti-inflammatory diet can be helpful to minimize flare-ups. Foods and supplements high in omega-3 fatty acids and linoleic acid have anti-inflammatory properties and can help reduce inflammation in the entire body, not just the skin. This includes many oils like fish oil and flaxseed oil. In addition, avoiding highly inflammatory foods, such as foods containing lectins like wheat gluten, will also reduce inflammation in the body. This means avoiding refined carbohydrates, such as breads, pasta and pastries– not so easy, but if you tend to suffer from inflammatory diseases, eating an anti-inflammatory diet is often an important part of keeping symptoms at bay.

Summary

  • Rosacea is a chronic inflammatory disease of the skin and eyes that causes redness
  • Avoid skin care products containing acids, fragrances, and irritating ingredients
  • Avoid friction-causing physical exfoliation, like scrubbing with rough sponges
  • Figure out your Rosacea triggers and try to avoid them
  • Use skin care products that soothe and calm the skin, and ingredients that actively reduce redness. Moisturize twice each day.
  • Eat lots of healthy foods, ideally with antioxidants and anti-inflammatory ingredients like fish oil, and minimize inflammatory foods like bread and pasta.
  • Consider Intense Pulsed Light or laser treatments if needed
  • Ask your doctor about topical medications for moderate to severe symptoms

Facials have become one of the most popular services in the aesthetics industry; however, you may not know all the benefits they can bring to your skin and overall health. Why should you try out a facial or hydrafacial?

Facials are not just a luxury. You can transform your skin with facial treatments, leading to smoother, glowing skin. Our goal at Glow Medispa is to help you feel confident in your skin. Facials are a huge help in that plan. 

Cleanse your skin

Many people know that facials involve cleansing the skin. In a medical facial, we are able to attain a much more thorough cleanse than you can at home, with high-quality medical grade cleansers and meticulous attention to detail. And with Hydrafacial, we are able to remove the dirt and impurities out of the pores with the device that is almost like a wet vac for your skin. 

Extract pores

In any facial, you will experience extractions. There are several different ways to extract debris from the pores. Most facials include hot towels or steam to allow the pores to open up, and manual extractions of each individual pore. The Hydrafacial uses a series of fluids that enter the pores and are removed, pulling the plugs and debris out with them.

Exfoliate dead skin cells

As you age, the turnover of your skin cells slows– this starts in your 20’s and continues to get worse over your lifetime. The result is a thick layer of dead cells that is dull, leathery and retains all the wrinkles and pigment they have picked up along the way. Both medical facials and Hydrafacial includes a thorough exfoliation step, removing the dead cell layer, leaving you with fresh new cells at the surface that are smoother, brighter and more even in tone.

Improve acne

Acne is formed because the layer of dead cells inside pores combines with dirt and debris to form a plug, and then bacteria grows behind the plug. This pimple has to grow big enough to notice, then big enough to erupt, and then takes days (sometimes weeks) to resolve. Facials exfoliate the dead cells and clean out your pores, helping to prevent future acne. With Hydrafacial, acne-fighting boosters can be used to further kill bacteria and decrease acne. Not all facials are created equal however– many spas and salons use ingredients that are not medical grade, and can actually make you break out. It is a great idea to ask what product line is used in a facial before having one in a new place.

Improve rosacea

Rosacea is a chronic skin condition that causes redness, dilated blood vessels, and often red bumps that look a bit like acne. A medical facial can use ingredients that minimize redness, and Hydrafacial boosters can be infused that treat the condition. Not all facials will help– some products can actually make redness worse– so carefully picking an expert who understands rosacea is critical if you suffer from it.

Improve sun spots

Facials can accomplish two bir things that can help improve sun damage. First they exfoliate the dead cells at the surface of the skin, diminishing the pigment that causes sun spots. Second, ingredients that suppress pigment, like tranexamic acid, can be added to the facial. Make sure you’re going to an expert who can customize your facial to your skin’s needs.

Anti-aging

Besides improving various medical skin conditions, facials can also apply anti-aging ingredients to the skin. Antioxidants help the skin resist the damage caused by the sun and UV rays. Collagen-stimulating ingredients can assist the skin preserve its natural thickness and health. Facials have an advantage in that these skin treatments are done immediately after exfoliation when they can best be absorbed by the skin to maximize the effectiveness.

Infuse medical-grade serums

This is a huge advantage of Hydrafacial, and one of the main reasons we offer the service at Glow Medispa. The skin is exfoliated and cleansed so that the medical grade serums can be absorbed well, and various treatments can be used to customize the treatment to any skin type of condition. Serums can be chosen that treat melasma and other pigment disorders, rosacea and redness, and anti-aging boosters.

Hydrate skin

One goal of any facial is to thoroughly hydrate the skin. This plumps the skin, restores a healthy barrier and produces a youthful glow. 

Improve lymphatic flow

Some facial treatments include lymphatic massage. This improves the drainage of the natural fluids and decreases puffiness. The Hydrafacial (the newest ones) include a lymphatic massage suction cup that delivers a very soothing experience while effectively clearing the lymphatics of the face.

Boost collagen with LED 

Many facial treatments include an LED light treatment. Red light from LED has been shown to stimulate the fibroblasts to make collagen. One of the main sources of aging is collagen loss in the skin leading to drooping and wrinkles. Stimulating collagen production is one of the best anti-aging procedures you can do to preserve youthful skin.

Get your glow on!

Facials, including medical facials and Hydrafacial, are not just a luxury! Besides leaving with beautiful glowing skin, you’ll also benefit from all of these additional skin improvements. Be sure to find an expert who can cater these treatments to your specific needs. 

When you invest in your skin with treatments like Botox or Dysport, it would be helpful to know exactly how long the treatment will last. Though the longevity of Botox is different between people, there are some general guidelines that can help you decide whether to have a Botox or Dysport treatment, and if so, the timing of when to do it. In this article I’ll also address Xeomin, Jeuveau and Daxxify.

How long does Botox last?

Botox is the most well known of the 5 neurotoxins that are FDA-approved in the United States. It starts to have an effect in a few days, but takes about 1-2 weeks to fully set in. If it feels uneven in the beginning, it usually evens out over that time period. After that, it lasts about 3 months on average, though this varies between people. It doesn’t suddenly wear off at 3 months. It slowly wears off over time, and by 3 months, most people find that it is completely worn off. 

How long does Dysport last?

Dysport is the next most popular neurotoxin in the US, and is the most popular in Europe. Dysport has a quicker time to maximal effect, usually 3-5 days. Dysport also tends to last longer than Botox, about 4 months on average. It wears off similar to Botox– slowly. 

At Glow Medispa, we offer both Botox and Dysport. We find that they are both equally effective at treating wrinkles, and can be used interchangeably. The cost is the same, so often the only true difference is the quicker onset and longer duration of Dysport compared to Botox. 

Are there other options?

There are 3 other neurotoxins approved for cosmetic use in the US: Xeomin, Jeuveau and Daxxify. We don’t offer them– why? Because we use Botox as the gold standard. If it is not better than Botox, we don’t offer it. 

How long does Xeomin last?

Xeomin was FDA approved in 2010. The onset of Xeomin is about the same as Botox, but we have found that it just does not last as long, about 2 ½ months. Xeomin is often cheaper than Botox, but you end up having to repeat the procedure more frequently, so in the end, you will not really save money. We offered Xeomin in the past, but people came back dissatisfied with the short duration of the treatment, so we no longer offer this product.

How long does Jeuveau last?

Jeuveau is another neurotoxin you may see offered at spas and aesthetic clinics. Jeuveau is very similar to Botox, and has a similar onset and duration according to other doctors who use it. The company that makes Jeuveau did a study that only looked at short-term results, with 2 studies that proved effectiveness over 30 days. The long-term duration wasn’t studied, so if you read the Evolus web site, they only say that most people receive 3 treatments per year. The company was rushing towards FDA-approval in 2019, and as far as I can discern, no further trials have been published to establish longevity. All that said, it acts a lot like Botox in its onset and duration. 

How long does Daxxify last?

Daxxify was the latest neurotoxin to win FDA approval in 2022. The company that makes it, Revance, designed a study to show that Daxxify (or Daxxi) can last 5-6 months. Because they claimed that it lasted almost twice as long as Botox, they charged almost twice as much for it. But it turned out in practice that Daxxi lasts about the same as Botox in real life. When we did a trial of Daxxi in our office, it did not even last as long as Botox. And it definitely does not warrant a higher price tag. As of this writing, Revance has started to drop its pricing, but that may not save the company. The company stock price has plummeted, and the future of Daxxify is uncertain. Because it costs more and does not actually last longer, we do not offer Daxxify in our office.

How to choose which neurotoxin to use?

Every person is a little bit different. In my experience, the vast majority of people find that Dysport lasts longer than Botox. But occasionally, it can be the opposite. If the cost is the same, then it may save you some time and money to try Dysport. But either way, we have found that people love the treatment. You will not miss those frown lines!

Want to learn more? Check out our full Botox Guide.

we are honored

We strive to do the best we possibly can every day and we are so grateful for our loyal patients who love and support us and make our job the best anyone could hope for. Not only did you vote us Best Med Spa-- we also won in the categories of Best Facial and Best Customer Service~ Thanks for voting for us!

how did the contest work?

The Seattle Times organized a contest across the entire Pacific Northwest. The 2023 Best in the PNW contest covered almost every industry, featuring local places, restaurants and businesses nominated and selected by our community to share the favorites they love. People from the entire region were polled over a 2-week period in July. The Seattle Times announced results to the public on Sept 24, 2023.

best med spa

Medical Spas perform many different aesthetic procedures from Facials to Botox. Glow Medispa offers one of the widest arrays of treatments in the industry, always meeting top standards for quality and results-- and always grounded in research and data, to ensure the safety and effectiveness of every service we offer. These include Botox, Fillers, Laser treatments, Skin Tightening and resurfacing, Skin Care, Body Sculpting, Hydrafacial and Laser Hair Removal.

best facial

Our signature facial and Hydrafacial are more than just spa treatments– we rejuvenate your skin with the best medical-grade  products. Our aestheticians pride themselves on their expertise on skin care and have continued training on medical maintenance of the skin and can advise, along with Dr. Dee and her medical team, how best to maintain naturally beautiful skin.

best customer service

Across all industries, Glow Medispa was singled out for its dedication to great customer service. We are especially grateful to our patients who recognized our devotion to always helping in whatever way we can to make sure you have a great experience. We will always do our best to take care of your needs, and our staff goes above and beyond to make that happen. We are so very proud to have won this category of Best in the PNW.

get to know us

The best way to find out more about our services is to schedule a consultation. Get in touch or schedule directly online.

Many people have heard of the Vampire Facial® (trademark of Dr. Charles Runels). Not quite as many have heard about Platelet-Rich Plasma (PRP) and fewer still have heard about PRFM or Platelet-Rich Fibrin Matrix. All of these use the same ingredients– growth factors from your own blood– to improve the skin and restore a natural youthful appearance. Read on to learn all about how these treatments are done and what they achieve for your skin.

How did PRP become a popular aesthetic treatment?

In January 2013, an Alabama doctor, Charles Runels, was using PRP and microneedling for facial rejuvenation and trademarked the term for this procedure the “Vampire Facial.” Later that year, Kim and Kourtney Kardashian very famously underwent the procedure and posted selfies afterwards. This helped to spur a surge in PRP procedures in the US and abroad. Kim later talked about regretting having the procedure– not because it didn't work– but because she was pregnant at the time, and could not have anesthetic for it. Without numbing the skin with topical anesthetic, it would hurt! 

In large part due to Kim’s fame, PRP became hugely popular. Not only because of her, but because it actually worked. In 2019 Kim Kardashian sued Dr. Runels for using her name to promote the procedure. That suit was settled in 2020. Meanwhile Dr. Runels is known for suing anyone who is not certified who uses the Vampire name to promote PRP and microneedling. Only doctors who pay for his certification can use the trademarked term. So, to be clear, for the purposes of this discussion, we are referring to PRP and PRFM procedures. Outside of Forks, there are no vampires in here in Washington. 

What is PRP?

To obtain PRP, you must first draw the blood and then spin it down in a centrifuge. The serum and platelets are then drawn off into a syringe (leaving the red blood cells in the tube). PRP is a golden fluid and is not actually bloody at all. We use special PRP kits, designed for making PRP in a sterile fashion so it can be reinjected. There are several companies that make high-quality PRP kits. Some kits, but not all, also have the ability to yield PRFM. There are some providers who make their own kits. I’m not a fan of this– though it does save a lot of money. But it brings in human error and the possibility of contamination into the process. If you are going to have a PRP procedure– ask what kit they are using.

What to know about PRP and PRFM

What is PRP used for?

PRP contains multiple growth factors that stimulate collagen and tissue regeneration. PRP has been used for decades for all kinds of purposes. It started in orthopedics, to help repair joint tissue. It has been used increasingly in aesthetics to rejuvenate the skin and facial tissues.

Because it is made from your own blood, it can be reinjected back into you to help stimulate healing and regeneration. It is often injected into the under-eye area, nasolabial folds and wrinkles of the lower face. It can also be used with microneedling, to allow it to be absorbed into the skin to stimulate collagen production.

PRP is typically used for a full-facial rejuvenation treatment that includes direct injections and microneedling. PRP can also be used to stimulate hair growth for people who are suffering from alopecia. You can read more about hair loss treatment on our website here.

What is PRFM?

When PRP is activated with calcium, it turns into Platelet-Rich Fibrin Matrix. PRFM over a few minutes turns from a liquid into a soft gel. It has been found that when PRP is injected, because it is a liquid, much of it diffuses away from the area where it was placed.

But PRFM, because it forms a gel inside the tissues, stays put and acts as a depot for growth factors. Over the years we have gone more and more towards using PRFM, because it has more potent results. 

At Glow Medispa, our PRP kits contain 2 sterile vacuum tubes. The first tube is to make PRP. The second tube contains activating factors and is used to turn PRP into PRFM.

What is PRFM used for?

PRFM is generally used for direct injections without microneedling. We especially love PRFM for the under-eye area, or the tear trough. This area often is the first place that we notice signs of aging. We lose the fat pad under the eyes, causing a hollow to form there. It is also the thinnest skin in the body, and the first place you tend to notice the skin thinning out and becoming more wrinkly.

PRFM is placed in the area with a cannula, and after several treatments, fills the volume and decreases the wrinkles. PRFM treatments have largely, though not completely, supplanted filler for the tear trough. Filler is still important when there has been a significant volume loss. PRFM injections can be performed in any area where increased volume, collagen and tissue regeneration is desired.

Summary

  • PRP – Platelet-Rich Plasma, is obtained from the blood, in aesthetics used for facial rejuvenation and as a treatment for hair loss.
  • PRFM – Plaetelet-Rich Fibrin Matrix, is activated PRP, is also used for facial rejuvenation, especially for the under-eye area.

Want to learn more? Call us or book online here.

Coolsculpting has been in the news a lot lately. In this article published in April 2023 from the New York Times, reporters describe disfigurement and the possible cover-up by Allergan, the company that makes the machines. As part of the investigation, they also published an article later that month specifically trying to determine just how often the worst side effects happen.

Ever since Linda Evangelista filed her lawsuit against Coolsculpting in 2021 (settled for an undisclosed amount the following year) people have been much more discerning about body sculpting in general. Read on for a summary of the ins and out of Coolsculpting.

Does Coolsculpting work?

Yes. It is possible to freeze fat, resulting in the death of fat cells and the reduction of fat in this area. The way it works is by using an applicator cup. The fat is sucked into the cup and frozen. The fat cells that die release their lipids into the body and over the next few months, they are drained away by the lymph system, and eventually excreted. 

What are the complications from Coolsculpting?

There are several problems with the technology. First, you can only kill fat that is able to be sucked into the cup. Any adjacent fat that is not sucked into the cup is left untreated. This can yield some very uneven results and what is often called “shelfing” when you can feel the edge of the treatment area.

Second, the skin overlying the area of fat loss ends up being loose, because it is no longer stretched over the fat. You have to have the perfect arrangement of fat to get an even result. Many people end up with lumpy areas covered by loosey-goosey skin.

There are also risks besides uneven results. There can be nerve damage from the freeze, but this is pretty rare. The other big complication is that the fat can react in an opposite way than was intended– it can grow instead of shrink. That is called Paradoxical Adipose Hyperplasia or PAH.

PAH when it happens is rock-hard, and does not respond to the normal fat removal treatments like liposuction. In most cases, the only way to get rid of PAH is surgery to remove it. 

How common is PAH?

This question is the focus of the second article in the New York Times mentioned above. When I was first evaluating body sculpting devices in 2015, I was quoted a rate of PAH of less than 1% by the sales rep. The company has maintained that this is the case for years.

The true rate turns out to be much higher than that, but it is impossible to know the exact number. According to the article, the true rate could be as high as 50% of patients may experience some degree of PAH. 

The massive difference in numbers has in part to do with how they define the rate. Allergan wants to use “per applicator” as the denominator, whereas in medicine we use the term “per patient.” Each patient experiences 4-8 applicators per treatment, and Allergan recommends at least 2 treatments per patient, so the total number of applicators each person receives is anywhere from 8 to 16.

Sometimes more if they do more treatments or more body parts. So the rate may be 8 to 16 times what the company reports, just by that alone. As a patient, wouldn’t you want to know how likely it would be to get PAH? 

The second part of why the number might be wrong is underreporting. Patients may not report this at all if it is minor. But also, when people have experienced PAH and sought restitution from the company, this was contingent on signing a confidentiality agreement. So Allergan would pay for corrective surgery only if you didn’t talk about it. What is the true number? One person I spoke with who used to work for Allergan said it was closer to 20%.

If that were true, I would think there would be a lot more very unhappy people out there given how many treatments have been done since the device was FDA approved way back in 2010. But we may never know.

Managing risk in Aesthetic Medicine

One of our essential tenets of aesthetic medicine at Glow Medispa: nothing in Aesthetics is worth any permanent harm. Whether the risk of PAH from Coosclupting is 2% or 20%, the risk of permanent harm is too high. For lots of procedures we do, there could be potential temporary issue– like a burn or hyperpigmentation. We do our absolute best to prevent adverse outcomes, but it will occasionally happen to any provider, no matter how experienced. However, permanent harm is (and should be) exceedingly rare. If you pick and choose safe effective treatments, you will minimize any risks. 

This is why at Glow we use non-ablative lasers for resurfacing (rather than ablative lasers which carry higher risks) and why we have Emsculpt Neo instead of Coolsculpting.

We have been using the RF and HIFEM technologies of Emsculpt Neo since 2018 with no adverse events.

Summary

  • Coolsculpting does work and can kill fat cells
  • The common complications from Coolsculpting are uneven results, wavy skin and Paradoxical Adipose Hyperplasia (PAH)
  • The rate of PAH is unknown but could be anywhere from 2 to 50%

There is a new way to enhance your eyes without surgery or needles. Upneeq is an eyedrop that acts on the eyelid muscles to open and brighten the eyes. Like Latisse (which makes the eyelashes grow longer and darker) it is a prescription that you can only get from a doctor. Almost anyone can safely use Upneeq, so it is quickly becoming a favorite, especially for anyone who wants to open their eyes up.

What is Upneeq?

Upneeq is an eyedrop containing 0.1% oxymetazoline hydrochloride. It acts on Muller’s muscle in the eye– one the the muscles that hold up the eyelid. 

How fast does Upneeq work?

Most people see the eye opening brighter in only a few minutes. It can sometimes take up to 2 hours to see its full effect, but this is rare. 

How long does Upneeq enhance the eyes?

Upneeq lasts about 8 hours. Most people use it first thing in the morning, but if you’re going to an evening event, it is best to apply the drops midday.

Are there any side effects from Upneeq?

Side effects are rare– only about 1-5% of patients. The most common adverse reactions with were eye inflammation, redness, dry eye, blurred vision, eye pain at time of use, eye irritation, and headache.

Is there anyone who can’t use Upneeq?

There is a rare form of glaucoma called Narrow-angle Glaucoma. If you have narrow-angle glaucoma, you can’t be prescribed Upneeq. 

Can I use Upneeq with contact lenses?

We recommend that Upneeq be dropped into the eye with no contact lenses in. If you wear contacts, we recommend waiting at least 15 minutes after using the drops before placing the lenses in your eyes.

Can I use Upneeq every day?

Yes! You can use Upneeq to enhance the eyes on a daily basis. Or you can use it only on special occasions. There is no long-lasting benefit or harm.

Want to learn more? Call us, or book online.

At Glow Medispa, we are always on the lookout for new and effective treatments for our patients who struggle with hyperpigmentation. Hyperpigmentation can show up on the skin in a variety of ways, including age spots, pregnancy mask (melasma), and dark spots from injury to the skin. 

What is Hyperpigmentation?

Hyperpigmentation occurs when there is an overproduction of melanin, which is the pigment that gives our skin its color. Melanin is produced by melanocytes, which are specialized cells in the skin. The production of melanin is regulated by a complex set of pathways, and any disruption to these pathways can lead to hyperpigmentation.

How does SkinMedica’s Even & Correct work?

SkinMedica's new Even and Correct serum and spot treatment target all 5 pathways of the melanin lifecycle, making them highly effective in treating hyperpigmentation. The serum and spot treatment are formulated with a unique blend of powerful ingredients, including ultra-concentrated lotus sprout extract, Tranexamic acid, and niacinamide. The spot treatment also contains retinol 0.25%. If you were using SkinMedica’s Lytera in the past, you will find that the new Even & Correct formula is even more effective.

What are the effective ingredients in Even & Correct?

The ultra-concentrated lotus sprout extract is a key ingredient in this formula. This extract is rich in antioxidants and has been used for centuries in traditional medicine to improve skin health. It has been shown to improve the appearance of uneven skin tone and reduce the appearance of dark spots. It does this by breaking up existing pigment in the skin. Even & Correct is the only product that can actually diminish the appearance of existing pigment in this way. 

Tranexamic acid (TXA) is another important ingredient in this formula, which is known for its ability to reduce the production of melanin. This ingredient has been used for years in the medical field to prevent excessive bleeding during surgery, but it has also been found to be effective in treating hyperpigmentation. By stopping melanin production, TXA prevents new dark spots from being formed.

Niacinamide is a powerful antioxidant that helps to reduce inflammation and improve the skin's barrier function. It has been found to be effective in reducing hyperpigmentation and improving skin texture.

Retinol 0.25% in the spot treatment is a powerful ingredient that helps to promote cell turnover and exfoliation. This ingredient is particularly effective in treating hyperpigmentation caused by sun damage. It decreases pigmentation by causing it to slough off from the surface of the skin.

The Even and Correct serum and spot treatment target all 5 pathways of the melanin lifecycle, including melanosome formation, melanin synthesis, melanin transfer, inflammation, and cellular turnover. This comprehensive approach ensures that hyperpigmentation is addressed at every stage of the process.

Works on all skin types

What makes these products unique is their ability to work on all skin types. Whether you have dark or light, dry or oily skin, these products are designed to be effective for everyone. They are also free of parabens, fragrance, and gluten, making them safe for those with sensitive skin.

How to use Even & Correct serum and spot treatment?

To use the Even and Correct serum, simply apply a small amount to your face and neck after cleansing. For best results, use twice a day. The Even and Correct spot treatment should be applied directly to the affected area once a day, preferably at night.

Is Even & Correct right for me?

In my experience, SkinMedica's Even and Correct serum and spot treatment are the most effective available to treat hyperpigmentation. They are clinically proven to improve the appearance of dark spots and even skin tone, making them a must-have for anyone struggling with hyperpigmentation, including age spots, pregnancy mask, and injury to the skin.

Questions? As always, we are here to help. Find our locations in Seattle and Kirkland here. Or book a consultation online here.

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