1. What is Kybella?

KYBELLA™ (deoxycholic acid) is the first, and currently the only FDA-approved non-invasive treatment that helps contour and eliminate the double-chin area by disrupting the fat cells that collect under the chin.

2. Does it hurt?

This treatment is safe and effective.  Kybella is administered through very tiny needle injections (same size as botox injections).  There may be some burning sensation that occurs for about 10-15minutes after injection. This does subside, but like with any injectable there are common side effects such as swelling, bruising, redness, numbness, and slight pain.

3. How many sessions does it take to see results?

The amount of sessions for treatment depends on the amount of fat that is in the area that is to be treated. Most patients will require a minimum of 3 treatments and a patient with a larger treatment are will require anywhere between 4-5 treatment sessions spaced 6-8 weeks apart.

4. Who’s a good candidate?

People who feel their jawline and neck area is saggy as a result of under chin fat, or those who see a double chin on front view or profile.  This is a great procedure for patients that have the desire to have that area of the double chin fat eliminated without surgery or liposuction.  Ideal patients are of normal body weight and not had surgery to the area.

5. Is there any downtime?

There is about 3-5 days of redness and swelling.  Some patients may consider having the treatment on Thursday or Friday to be optimized for going back to work on Monday.

7. Where does the fat go?

When Kybella is injected into the fat beneath the chin it eliminates the fat cells in that area. Once those cells have been destroyed they cannot store or accumulate fat and they are processed through your body’s metabolic system.

8. Does it help with saggy, jowly, or droopy neck and jawline skin?

During the clinical trials on Kybella it was discovered that the treatment did induce new collagen production which in some candidates gave significant skin tightening.  If a lot of neck skin laxity is present, you may consider pairing this treatment with radiofrequency tightening for even treatment of jawline and neck bands with Botox or Dysport.

Contact us today for an evaluation if you are interested in the procedure!

… Shared by the TDI Team

One of the most common complaints we hear from patients is the appearance over time of vertical lip lines, commonly referred to as “smoker’s lines” or “lipstick lines”. These stubborn wrinkles are caused by a variety of factors, including age, genetics, repetitive lifestyle habits, and in some individuals, smoking.

Vertical lip lines, or wrinkles around the lips are often NOT caused by smoking, despite its common reference as smokers lines. In fact, they are mostly caused by repetitive regular lip movements, and in some individuals, this movement can be hard to avoid. These lines are noticeable when lipstick “bleeds” into these fine lines, which earns these wrinkles their other common name “lipstick lines.”

As with all wrinkles, preventing their formation or deeper etching of these lines is the first line of defense.

• Use sunscreen regularly to protect collagen breakdown
• Stop smoking, if you do smoke. Even occasional smoking greatly expedites the formation of these lines!
• Frequent use of straws or drinking from a water bottle nozzle causes the firm pursing of the lips that can lead to these lines! Drink from a glass, or from pour bottles of water instead of the sports topped bottles.

Vertical Lip Lines Treatment

Once these vertical lip lines develop, treatment usually requires a soft approach so the area still looks natural, but without the lines.

Fillers such as RHA and Belotero are extremely thin and flexible, making them the best options to treat these pesky wrinkles. Softer, thinner hyaluronic acid based fillers can provide a smoothing of these vertical lip lines without adding any bulk or volume to the lip itself. Fillers used in lip lines are composed of hyaluronic acid, a naturally occurring sugar molecule in the body. Our natural supply of hyaluronic acid diminishes over time with age, and fine lines and loss of collagen occurs as a result. Fillers with small particle sizes and increased flexibility like the RHA 1 fillers are uniquely formulated to re-deliver this naturally hydrating substance to minimize fine vertical smoker’s lines while still allowing fully natural movement in the lip area. Contact us to get a consultation with Dr. Chiu to choose the most customized, natural-feeling filler for your desired outcome.

In FDA studies, 98% of participants treated with fillers in this area reported an improvement in lip wrinkles. Over 75% of subjects still showed improvement 9 months after their initial injection. There is no downtime to the procedure, and the treatment takes approximately 30 minutes.

Other Treatment Modalities

Because “smokers lines” are so pesky, sometimes multiple treatment methods may be needed to result in complete correction.

• We often use very small, expertly injected amounts of Botox around the mouth to relax the repetitive pursing that causes etching or deepening of these lines. This not only helps the appearance of smoker’s lines by relaxing the muscles that cause vertical lip lines, but it can also improve the longevity of a product like Restylane Silk.
• Topical creams containing retinoids or polyhydroxy acids can gently resurface and thicken the collagen in the deeper layers of the skin, helping to soften these wrinkles. At The Derm Institute, we love our SkinLab Airbrush Retexurizing Cream, as it contains resurfacing acids and antioxidants to smooth the appearance of fine lines.
• Physician strength chemical peels can remove the upper layers of the skin, allowing new skin to grow and plump the area, diminishing the appearance of these lines. Deeper peels, including phenol, TCA, and Baker-Gordon-Phenol are handled only by Dr. Chiu can be effective to soften this area around the mouth.
• Microneedling promotes neocollagenesis, or the production of new collagen stimulated by microinjury induced by tiny needles to soften fine lines and improve skin texture. This is a great, cost effective way to treat this area.
• Platelet rich plasma (PRP) injections can help improve and smooth the skin in this delicate area.
• Lasers can cause microzones of collagen repair which resurface vertical lip lines.

Subtle, artful, and expert treatment is key, as this area can easily look “done” or overfilled. But in experienced hands, smokers’ lines can be totally banished without any evidence that a procedure was done. Dr. Chiu is an injector trainer and renown expert in the use of injectable fillers. Contact us today for a consultation.

. . . Shared by the TDI team

Men have a growing interest in cosmetic dermatologic treatments. Wrinkles don’t just affect women, so it only makes sense that wrinkle treatments can be used by both MEN and women.  BOTOX has been used for cosmetic purposes to relax frown lines and crow’s feet for over  ten years now, and its use in men continues to grow rapidly annually.   Wrinkles are also not the only thing Botox is used for—often men use products such as Botox to decrease sweating, or hyperhidrosis in the armpits or hands.  This can help a socially annoying condition for up to a year!

Men often use BOTOX to get rid of wrinkles, frown lines, and achieve a generally smoother face for a more youthful, rested, and approachable look?  For all you guys who are worried that this procedure is just for women, fret not. BOTOX or “Bro-tox” for men, has seen a 258 percent increase between 2000 and 2010, according to the American Society of Plastic Surgeons.

Bro-tox, which is the name given for male Botox injections, is on the rise as it is one of the most subtle  non-invasive skin rejuvenation procedures on the market.  The procedure is fast, virtually painless, and easy.   Bro-tox injections leave no signs of having “work done,” and men are able to get the smoothing, lifting and relaxed appearance without facing the stigma associated with cosmetic procedures. According to the American Society of Plastic Surgeons, in 2011 there has been a 56% increase in minimally invasive procedures in men such as brotox injections. The brotox injection is the most popular.   Increasing numbers of guys are considering non-invasive cosmetic procedures to appear more approachable, to stay competitive in an ever younger millennial workforce, and to generally increase their confidence.  Men and women have very differing  facial anatomy. Men’s skin is thicker, with more oil glands and more hair than female skin, and the aging process is different in the two genders. Women have more fat pads in their faces, and as time marches on the fat pads diminish and the skin begins to sag. Because men have less dense fat pads, the sagging process isn’t as apparent, but stronger muscles in the forehead and around the eyes can lead to deeper, etched lines in men. In general, men can be treated with the same Botox techniques as women, but often require more units to treat the larger muscles in their face. The most common cause of an inadequate result in male patients is under-dosing. Forehead lines require care, as many men with horizontal lines have low-positioned eyebrows, and excessive relaxation of the lower frontalis muscle can drop their brows further. Special consideration should be given to the masculine male brow when treating men.  Going to an experienced master injector such as Dr. Chiu is important to avoid a “done” or even feminized appearance.

BOTOX is a low-concentrated neuromodulator  that blocks nerve impulses, causing the muscle to become temporarily paralyzed. The process relaxes the muscles that cause wrinkles, reducing the appearance of forehead wrinkles, crow’s feet, and frown lines. BOTOX can also be injected into the muscle and within days, the lines in your bow decrease and your brow line is elevated, leaving you a more youthful, relaxed looking face.  Often our patients state that the “11” lines between the brows make them appear angry or unapproachable, and that Botox softens this effect greatly.

Since this is a nonsurgical procedure, you can be in and out in no time. Pop by before work or after the gym for a quick fifteen-minute visit and look younger instantly. Patients are recommended to come every four to six months to receive new BOTOX injections.

Another great use for Botox is for underarm sweating. Men and women both can benefit from this. Men sweat more than women, and the area of greatest concern is the underarms, although sometimes excessive sweating on the hands and feet can interfere with daily social interactions. The first long-term study of Botox injections in the treatment of the common sweating disorder shows the injections can safely reduce underarm sweat for up to two years. Botox Treatment of the underarm is a very fast (10-15 minutes) and nearly painless procedure when an appropriate numbing cream is applied.  How does Botox reduce underarm sweating? The drugs contained in the Botox treatment will send signals to the nerves to temporarily put a stop to the production of sweat in the underarms.  This is a very safe procedure that is also increasing in popularity.

Botox is one of the most easily administered and highly effective wrinkle treatments, and because of its efficacy, high degree of satisfaction, and affordability.

Our male patients are incredibly happy with their procedures, and we have an over 90% return rate for male patients here at The Derm Institute.  So be excited and encouraged to try it out! — Botox is not just for women!  A cosmetic consultation is all it takes to get the conversation started.