5 Places You Didn’t Know You Could Use Injectables ••To Fix!

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1. Botox in your scalp aka “BLOW-TOX”. Wish your blow out would last longer? There’s help! Botox in the scalp decreases oil and sweat production on the scalp, which are the pesky things reverts your hair to its pre-blowout frizz. Now get longer lasting smooth blowouts with BLOW-TOX!

2. Fillers in the earlobes. Have you noticed droopier earrings when you wear them? Or the pierced earlobe looking elongated? With time, collagen loss occurs in the earlobes and they flatten, and the weight of earrings can make the lobes look saggy and draggy. A smidge of filler in the earlobes can correct this instantly and get those diamond earrings to frame your face beautifully again.earlobe correction


3. Kybella in the armpit pooch. Summer is here, and strapless dresses reveal that little pooch of fatty skin under the arms no matter how thin you are! Consider Kybella, the first FDA • Approved injectable that dissolves fat. In a single session you can get PERMANENT fat reduction in this area!








4. Voluma for a non-surgical rhinoplasty. Annoyed by a flattened profile, a slightly not straight nose, or a bump on the nose? Juvederm Voluma when used in expert hands like Dr. Chiu and yield AMAZING non-surgical instant results. She can straighten a crooked nose, build height to a flat bridge, refine and tilt up the tip. Our patients think the results are truly magical. Lasts up to 2 years!Non-Surgical Rhinoplasty









5. Sculptra for vertical boob lines. Notice when you wake up in the AM, there are creases on your chest and especially on between your breasts? This gives the chest a saggy, aged appearance. Sculptra, typically in 2 sessions, rejuvenates this area beautifully, improving both the skin texture, correcting the lines and giving the breasts a subtle lift. A must treatment for those who like V or plunging necklines!

Advanced techniques of injectables can be used to correct all sorts of problem areas you never thought there was a solution for. Feel free to call our office (link) for any additional information. We are experts at keeping you looking and feeling confident and beautiful in your skin.

Get The SKIN•NY On The Newest FDA•Approved Filler: VOLBELLA

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Want glossy pillowy lips without the dreaded “trout pout”?  Now is the time to put your fears away—Vobella is here!

Before & After

Volbella is the newest filler approved by the FDA.  Like its cousin, Voluma, Volbella comes from the makers of Botox, and is comprised of cross-linked Hyaluronic Acid, but its defining characteristic is its ultra smooth, ultra fine, and ultra soft consistency, making it an ideal filler for pesky lines around the mouth, aka “smoker’s lines” (although these occur in non-smokers too!), and for those who want a very natural lip rejuvenation.


There are so many fillers on the market–what makes Volbella different?

Volbella is part of the Juvederm Voluma family, uniquely characterized by VYCROSS technology, which through special efficient crosslinking, allows longer lasting results with minimal swelling.

  • Minimal swelling effect, unlike other lip fillers on the market where you have a few days of swelling before the lips settle down.
  • Not for building enlarged lips, more for a glossing, slight plumping effect, like wearing the best lip gloss you can imagine 24-7.
  • Ideal for fine etched lines around the mouth, including vertical, “smoker appearing” lip lines.
  • Can be used for etched fine wrinkles other than the lip area as well.



How long does it last?  What kind of results can I expect?

Dr. Chiu has perfected her TDI “Lip Glossing” technique with lip fillers.  Her technique with Volbella, as well as other lip fillers is to achieved a “just kissed” look—where the lip is slightly plumped, has a glowing sheen, and a dewy appearance.  Just a touch of sexy . . . and with Volbella, the results are so natural no one will know!   Let’s say your secret will be sealed with a kiss . . . And it’s long lasting—up to a year!

When will it be available in the United States?

Because Dr. Chiu is a nationally recognized master injector and physician trainer, The Derm Institute will be among the first clinics in Los Angeles to offer Volbella, this revolutionary new filler which is slated for wider release in October.  Contact the office to get on the waitlist today!

Then, stay tuned for Vol-Lift . . .  in the TRIAD of VYCROSS fillers. . . also coming this year.

Volbella-Loveyourlips-6-2016… Shared by the TDI Team

Frequently Asked Questions: Kybella

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The Derm Institute is designated by Allergan as a Kybella Center of Excellence


1. What is Kybella?Kybella

Kybella is an injectable formulation of deoxycholic acid, a naturally occurring molecule I the body that aids in the breakdown and absorptions of fat.  When injected into areas of unwanted fat, Kybella causes the destruction of fat cells.  In 2015, the FDA approved the use of Kybella to treat submental fat, otherwise known as a double chin.  At The Derm Institute, we call it mini-liposuction in a syringe, and we have been designated by Allergan as a Kybella Center of Excellence due to Dr. Chiu’s extensive experience and pioneering techniques.

2. What areas can be treated with Kybella?

Kybella is most commonly used for the removal of fat underneath the chin.  At the Derm Institute, we are the South Bay and Los Angeles’ Kybella Center of Excellence.  This means Dr. Chiu has extensive experience in contouring the lower jawline, double chin, and also uses Kybella for other areas of body contouring, such as the armpit fat, bra bulges, and lower buttock fatty folds.

3. Are there any off-label uses for Kybella? If so, are they safe?

Off label, Kybella can be used for other smaller areas of unwanted fat on the body.  Dr. Chiu has used it with great results in patients for:

  • Armpit pooches
  • Back fat
  • Bra bulge
  • Inner knee fat
  • Lower buttock fatty folds

4. Kybella vs. liposuction for double chin? Which would you recommend and what is the difference?

If you have a double chin or other small area of stubborn fat where you want more contour and definition, then consider Kybella a safe alternative to liposuction and surgery.  Only you and Dr. Chiu can decide if Kybella is the right treatment.  Typically, Kybella treatment requires 2-4 sessions.  Liposuction typically requires 1-2 sessions, but some patients do not like to undergo surgery, or have scars from liposuction.  Kybella treatment does not leave any scars as it is injected through a very small syringe.

5. What is recovery like for Kybella injections?

There is some swelling right after Kybella treatment, which typically is most prominent in the first 2-3 days and is typically completely resolved in a week.  After day 3, most swelling is not noticeable to others, although a scarf or a mock turtleneck can help camouflage.  Dr. Chiu recommends scheduling Kybella treatments on Thursdays or Fridays to allow healing to occur over the weekend.  Over the following month, you may feel (but not see) some bump under the skin of the treated area.  This firmness signifies Kybella is working to dissolve the fat.  Once the fat is dissolved, your body will naturally absorb the fat cells.

6. How long do results from Kybella injections last?

The results gained with Kybella are considered long term and the fat will not return once dissolved if the weight of the patient remains stable.  FDA studies show maintenance of improvement at 5 years after treatment when patients maintained a stable weight.

7. What do I do if I gain weight after using Kybella?

Because double chin fat, or any area treated with Kybella is composed of fat cells, with significant weight gain, the fat area can possibly but not always return.

8. Are Kybella injections painful?

There is little pain during the Kybella procedure.   There is a slight burning sensation when the product is administered, but at The Derm Institute, we use topical numbing and ice to ensure comfort for our patients.  Two to four sessions are recommended with a follow up of 6 – 8 weeks between each treatment.  Dr. Chiu and staff try to make each treatment as comfortable as possible.  Before treatment begins, Dr. Chiu’s medical assistant will ice and numb the area with a numbing cream. This helps with any discomfort during the Kybella procedure.  there is some pain associated with the reaction that causes the fat breakdown.  This is not severe but may cause the area to become tender.  Dr. Chiu has a post-care plan for Kybella patients:

  • After the treatment, DO hold ice packs on the areas that are treated with Kybella gently for a few times that day.
  • Treated areas may be red, inflamed, swollen, and bruised for the first 2-7 days.
  • DO resume all normal activities include exercise as long as it is comfortable for you.
  • DO take ibuprofen, motrin, or advil if needed for discomfort after the treatment.
  • If bruising occurs, apply topical Arnica gel, drink fresh pineapple juice, and/or take Bromelain supplements to help bruising resolve faster.
  • Bruising can be covered with makeup.

9. How long is a Kybella treatment?

Kybella is an incredibly quick and easy “lunchtime” procedure.  Most patients are in and out within 30 minutes, most of the time is used to allow topical numbing to work.

10. How many Kybella treatments do I need to see results?

Every patient is different.  As an expert injector for Kybella, Dr. Chiu will help you evaluate what areas are bothersome.  Most patients need 2-4 sessions spaced 6-8 weeks or more apart.  Dr. Chiu’s extensive experience and expert technique with Kybella allows for contouring of the jawline and faster noticeable results, even after one session.

Groupon Injectables . . . what’s the downside?

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coupon deals

There is no denying that cosmetic procedures can be pricey . . . so it can be tempting to look for specials and deals at the local salon or Groupon. Patients often ask us, “how come they can offer botox for so cheap?”

Like many things, you often get what you pay for . . .

The application and use of various non-invasive treatments combined with the artistic and expert techniques utilized by Dr. Chiu is what truly sets The Derm Institute’s treatments apart. There are no shortcuts, inappropriate dilutions, or non-original manufacturer discount supplies ever used in our clinic. Dr. Chiu and The Derm Institute team are committed to exclusively providing advanced, expert, cutting edge and artistic facial rejuvenation safely.

Injectable neuromodulators such as Botox and Dysport, and cosmetic fillers such as Juvederm and Restylane are highly regulated FDA-controlled drug treatments. The raw cost of Botox and fillers direct from the approved manufacturer is a set price. Counterfeit, illegally imported, near expiration, or inappropriately diluted product has been an increasing problem in the US as price competing medi-spas and nurse injectors are opening all over the country.

Discount cosmetic centers often cut costs whether knowingly or not by using illegal or counterfeit, less expensive product. Less experienced injectors, often non physicians, although this decreases treatment pricing for the patient, it can at times increase risk of side effects. All medical and cosmetic procedures can rarely result in a complication. Treatment administered by a Board-Certified Dermatologist, like Dr. Chiu, who is extremely experienced in cosmetic procedures can reduce not only the likelihood of a serious complication, but if something does occur, she is specially trained to know how to recognize and resolve any issues.

Often, the cost quoted can also be misleading. Coupon deals show examples like $500 per syringe, but it may take a less experienced injector much more product to achieve the same result. So your overall cost to achieve a desired look may actually be more! It is not uncommon we get patients who tell us they spent thousands and did not see a visible difference they were happy with.

Dr. Chiu and The Derm Institute Team are sincerely committed to fair pricing with the most advanced, expert techniques used with artistry. We apply the highest standards to everything used in our clinic, and we only use the most high quality products, including pharmacy grade numbing cream, German imported microneedles for comfort, and of course, only FDA approved, manufacturer direct medications and treatments. Every expiration date, lot number, and hologram is noted and recorded. Come see the difference for yourself . . .

…Shared by The Derm Institute Team



TDI Effortless Lift Infographic

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The TDI Effortless Lift is The Derm Institute’s Patented Liquid Lift Procedure. An exclusive, essential package dedicated to the natural lift and glow everyone desires and can achieve by catering to individual skin beauty needs.

Chiu - TDI Effortless Lift FINAL

Are your hands giving away your age? TDI’s Radiesse “Hand•Lift” to the rescue!

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As we become more expert and advanced at rejuvenation of the face and neck, more and more patients are noticing the changes that occur over time on the hands. This is one of the most age-telling areas on the body, as it is almost always exposed.

Chronic sun exposure and time thins the skin and collagen, and the skin becomes lax and discolored with sun or age spots. The hands lose plumpness and firmness, becoming more “bony” appearing, with veins and a skeletal appearance.

Treating these changes is an incredibly easy set of non-invasive, non-surgical procedures that result in extremely high satisfaction and duration of improvement (1-2 years!).



Step 1: Replenish Volume

The FDA recently approved Radiesse as the first and only injectable filler to correct for thinning, bony, skeletal appearing hands that have more bone and vein show. Radiesse instantly restores and replumps to give a more youthful appearance. Radiesse is a filler made of microspheres of natural calcium hydroxylapatite, which provides a scaffold to stimulate your own body’s production of collagen. The product has been used safely for facial rejuvenation for many years, and is eventually metabolized out of the body.

Placed beneath the skin on the back of the hands, Radiesse provides instant smoothing of wrinkles and long lasting results up to 1-2 years in a 15 minute treatment session! The result is smooth, beautiful, and natural.


Step 2: Brown Spot Removal

In an easy treatment with either a V-beam or IPL laser, 1-2 sessions can clear brown spots on the hands with very minimal downtime. These lasers target the discolorations on the hands so the skin appears even toned and not “spotty.”

Step 3: Maintenance and Nourish

The texture of the skin is important to maintain. Keeping the hands sun protected, nourished, and moisturized is important to discourage the return of brown spots, reduce fine lines and crepiness, and also give the appearance of healthy thickened skin.

  • Daily sunscreens for your hands should be reapplied throughout the day. We powder them up with Sunforgettable SPF 50 Powder for quick reapplication in the car.
  • Nightly treatment with a product like Revision’s Lumiquin hand cream with licorice root extract, Vitamin C, and peptides brighten and reduce fine lines. This keeps the hands smooth and soft. Dr. Chiu loves this product. She keeps a tube on her bedstand and puts just a pea-size on the back of the hands nightly.
  • Light Peels can maintain the suppleness for hand holding . . . Try SkinLab’s Boost Weekly Power Peel Pads.

Extra tips:

  • If you drive a lot, use fingerless sunprotective gloves, available on amazon
  • If you get gel manicures, request a LED light for curing, NOT a UV lamp

All these procedures and products are available at The Derm Institute. Our hands do so much for us every day, isn’t it time they got a bit of pampering?


Call The Derm Institute today for specials celebrating FDA’s recent approval of Radiesse for hands at 310-939-9800.

…Shared by The Derm Institute Team

Giving Superhero Makeovers for the Surgically Averse Man

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We all know the look of a masculine, virile man . . . Modeled after superheroes as we know them, the chiseled jawline–no double chins, no slackening of skin– gives the sense of confidence, strength, being in shape and of course youth.

More and more men are seeking non-invasive cosmetic procedures to give them not just a competitive edge on aging, but in the workplace as well. A well defined jawline, without saggy double chins, portends strength and success, yet was previously determined mostly genetically. Nowadays, subtle and completely natural appearing enhancement can occur in about 30 minutes at a dermatologist’s office.

Look at profile pictures of CEO’s and you will see the chosen LinkedIn shots tend to be angled to highlight a sharp, masculine, superhero like jawline. Maybe it is our obsession with superman and batman (who prominently only shows his jawline), but this feature somehow conveys to the human eye a sense of control, power, and intensity–characteristics that often define success.

Weight loss, getting fit, and skincare do not address the jawline laxity that starts occurring as early as 30s in both men and women. That is because bony remodeling and the resorption of jawbone occurs over time, causing the skin to appear more lax over the weakened underlining scaffold of bone. As the skin loses laxity, the under chin fat pad (aka the dreaded double chin) becomes more prominent, and that border between the neck and jaw somehow starts to blur. Some men are under the misbelief that working out can improve this–but it can often worsen the condition, as stronger neck muscles can pull down the jawline skin even further.

Most men who come to The Derm Institute or seek a dermatologist’s help can’t identify this exact issue. But they do notice a slackening and tiredness of the face, a sense of weight gain that shows around the jaw, and of course the double chin. There’s a reason men in their mid thirties suddenly sport some sort of facial hair–as this often masks the lack of sharpness in the jawline and gives a shadowing to give an impression of definition.Malejawline


For all you superhero, CEO, and success inspired men out there– don’t fear, nowadays there are numerous options and methods to re sculpt the masculine jawline:


1. Botox/Dysport.

Advanced techniques can be utilized to reduce the downward pull of muscle fibers in the neck, known as platysmal bands, on the jawline to give the face better contour. This is an easy, painless 15 min procedure.

2. Kybella.

For those with a prominent fat pad under the chin, a newly FDA approved series of injections can be used to essentially destroy the fat cells that give you the dreaded double chin appearance. Non-invasive and with minimal downtime, this is an exciting new development in jawline rejuvenation.

3. Fillers.

Some patients are born with a “weak chin”, or the bony remodeling over time makes the chin appear smaller, losing the strength of a sharp jawline. With products like RadiesseVoluma, Restylane Lyft, and Sculptra, advanced cosmetic injectors such as Dr. Chiu can resculpt, relift, and redefine the entire chin and jawline area in less than 45 minutes. Results are immediate for those who love instant gratification with minimal downtime.

4. Radiofrequency tightening.

Breakdown of collagen with age, sun exposure, smoking, and genetics causes thinning and loss of elasticity in the skin. Radiofrequency can heat the collagen, stimulating new collagen production and tightening of collagen fibers to redefine the jawline.

A lot of these procedures can be combined for the best results depending on each individual’s needs. The Derm Institute is committed to a comfortable low pressure environment for every patient to discuss their concerns. See someone with extensive experience in treating men, such as Dr. Annie Chiu, as specific techniques are important not to feminize the male face. Instead we can help you work towards a chiseled, non-jowly, confident you.

You are all superheroes at TDI 🙂

…Shared by The Derm Institute Team

Get Lyfted! FDA Approves Restylane Lyft

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Restylane LyftIt’s here! The FDA has approved Restylane Lyft! This is a dermal filler with a history of longstanding safety. It is a unique product that has over 15 years of proven safety data, and is a hyaluronic acid product previously known as Perlane.


What’s New?

This is the First and only FDA approved filler that is indicated to address multiple areas of the face. This includes the cheeks and smile line areas. These are the areas that have a more pronounced appearance as we age because this is where we lose the most volume in our face.

Its WOW Factor

TDI refers to Restylane Lyft as the “one syringe wonder”. We can use it to safely and effectively lift the cheeks, soften the smile lines, turn up the corners of the mouth, and soften under eye circles. It is a great choice for someone who may be looking for a product that can target a large area for volume enhancement, achieving a natural and beautiful lift.

Why should you use it?

With age we lose collagen and this causes volume loss in the face. This leads to sagging or droopy areas of the face. This can lead to heavy folds near the mouth and feathering of the central part of the face. Restylane Lyft is specifically targeted to provide top tier results when it comes to restoring volume and lifting the face in these areas.

Schedule an appointment by clicking here. Let TDI help get you Lyfted!

…Shared by The Derm Institute Team

Kybella Injections for Chin Fat: What You Need to Know

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  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.

doublechin edits2

  1. 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.


  1. 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.


  1. 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.


  1. 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.


  1. 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.


  1. 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

Look Rested. Look Younger. But don’t look “Done”!

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With the recent chatter about Renee Zellweger and other alleged celebrity dramatic changes in appearance, we hear a lot of concerns from patients about cosmetic procedures making them look “fake” or “done”. At The Derm Institute, we have lots of secrets to keep your look refreshed without changing who you are. We want everyone to feel confident and comfortable in their own skin, and we know how to simply make you look like the very best version of YOU.

volumaOne of our favorite products to achieve the soft, natural and rested appearance is with the filler product Juvederm Voluma. Voluma is made of a patented cross-linking of a naturally derived sugar molecule called hyaluronic acid. This VyCross technology gives Juvederm Voluma a more significant lifting effect and longer lasting results than other cosmetic fillers currently on the market.

Voluma utilizes your own body’s natural ability towards hydration around sugar molecules like hyaluronic acid.  The injected Voluma attracts water and collaborates with collagen for production of elasticity and volume in sunken areas of the face to bring a natural, softer, rejuvenated appearance.

Voluma is classically used on mid-face areas such as the cheeks, as they do drop with Voluma before and aftergravity over time.  The first signs of a sunken and tired appearance are normally at the mid-face/cheeks.  The cheeks have the greatest surface area on our face compared to the rest of our face.  So it is best to keep the cheeks higher for a seemingly rested face, and to reflect light flatteringly instead of a shadowed, tired appearance.

When youthful volume is restored in the cheek area, a natural luminous glow appears furthering an appearance of rejuvenation and rest.  Think about the glow makeup artists strive to create using “highlight powder” on high point areas such as the cheek bone.  Lifting facial features with Voluma is achieving this from the inside out.  Recent studies also show Juvederm Voluma may also induce local collagen production, giving the skin texture a brighter, dewy appearance.  Our patients are loving their results.

Dr. Chiu is a master Juvederm Voluma injector, and she utilizes it not only for cheek lift, but also to rejuvenate hollowed temples and undereye areas.  Non-surgical shaping of the nose and chin augmentation can also be done beautifully and naturally with Juvederm Voluma.  Dr. Chiu can add additional lift to a flatter nose, or build a soft chin that augments the heart shape of the face.  This is an extremely popular procedure among our Asian patients.

With predicted last time of around 18-24 months.  Voluma is great for a natural and rejuvenated appearance while avoiding the “taut” and “fake” look.   Results are seen immediately, with a chance of bruising for 2-7 days after the procedure with slight redness for the first few hours.

Looking dewy fresh and rejuvenated without looking “done” or looking like you “tried” is an art.  Luckily TDI and Dr. Chiu has the tools to master this art, you just need to provide us with the canvas!  For more questions please call us at or email to schedule a free consultation on how you could look more rested.  Dr. Chiu and TDI are always here for you!

. . . Shared by the TDI team.

On the Cutting Edge . . . Beauty Breakthroughs on the Horizon

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2015 is set to be an exciting year for new cosmetic procedures. At The Derm Institute, we are always on the cutting edge to deliver the newest and best procedures in Cosmetic Dermatology. Below are soon to be offered brand new procedures to keep you confident and happy in your skin.

1. Restylane Silk for “smoker’s lines”, “lipstick lines”, or vertical lip lines.

Modified 11/22/06 19:03 AlterImage® V3.10Repetitive puckering of the lips from pursing or frequent use of straws and water bottles can cause creasing wrinkles around the mouth area. Restylane Silk was recently approved for use in the United States by the FDA to treat these pesky “smoker’s lines” that age the face. Dr. Chiu is one of the first injectors to offer this product exclusively to TDI patients before its official launch. Restylane Silk differs from classic Restylane, in its particle size. Because of its makeup of finer particles, Restylane Silk will be a “fine line” filler, perfect for those stubborn thin smoker’s lines around the lips, or other fine, shallow lines that can look etched in the skin. The smaller particle allows for a smoother, less bulky fill for a more natural appearance.


  • Vertical lip lines or “smokers” lines
  • Etched lines on the cheeks or in the smile area
  • Stubborn forehead or glabellar etching that is not fully treatable with just a neuromodulator such as Botox or Dysport
  • Horizontal necklace lines on the neck area

2. VANQUISH for the thighs, hip area, and arms

At The Derm Institute, we have been getting amazing results around the abdomen, flank, waist, and back with non-invasive fat elimination utilizing radio frequency with the VANQUISH system.  We are now introducing a new subsystem to use the same efficient, yet comfortable technology to treat the thighs, hip area, “saddle bags”, and arms.  Unlike some of the other fat elimination systems in the market, VANQUISH is unique in that it can treat a more comprehensive area:  such as both the inner and outer thigh to reduce the entire thigh circumference if desired.  Treatments will be once a week for 4 weeks, with each treatment lasting about 45 minutes.


  • Inner thigh and outer thigh contouring and reduction in fat
  • Reduction in excess fat around the hips or “saddlebags”
  • Inner knee fat pockets
  • Upper arm fat for more attractive contours

3. Kythera ATX-101 

This is procedure in late clinical trials with the FDA, with likely launch in early 2015. Kythera ATX-101 is what Dr. Chiu considers a “game changer” in the rejuvenation of the face and neck. The procedure consists of a series of simple injections in the area under the chin and jawline to reduce the fat and sagging that occurs over time. This is a first in class non-invasive cosmetic treatment to better define the jawline by treating the underjaw and underchin fat. Fat is disrupted by ATX-101 and clinical studies show some possible collagen stimulatory effects that tighten the area and allows for a more defined jawline and neck.


– For the treatment of a “double chin”

– For the treatment of fullness or jowls around the jawline and neck area

– In expert hands, for the treatment of other small areas of stubborn fat pockets such as the neck and arms.


. . . Shared by the TDI Team

Fillers: A weapon to banish “smoker’s lines” or vertical lines around the lips

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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 oftensmokers lines before and after rest-1 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

Three Tips to Brighten Undereye Circles

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Under eye circles can be caused by a number of different things: lack of sleep, sinus problems, sun exposure, age, allergies, smoking, and even genetics.  The appearance of undereye circles results from where the bone along the orbit of the eye transitions to just skin.  Naturally, there may be a groove in this area that makes the undereye appear hollow, shadowed, and thus darker.  The skin is also very thin in this area, allowing the underlying structure to be seen through the skin.  Blood vessels and muscle can all be slightly seen through thin skin, again making the area appear dark or pigmented.  There are several different approaches to help manage and treat this troublesome issue that many of us suffer from. This includes prevention, treatment, and the benefits of cosmetic procedures for under eye circles. This information will hopefully help you decide which approach (or combination of them!) to take, and which ingredients to look for in products designed to help get rid of those dark circles.


1. Prescription Retinols

Products that include a retinol, especially prescription strength retinols such as Renova are an essential part to a good skincare regimen. Retinols helps with cell turnover and collagen synthesis, and can be used for restoring and reviving skin around your eyes by thickening the collagen to help reduce wrinkles and crepy texture. Retinols can be a bit irritating to use, so make sure you follow the correct directions.



2. Eye brighteners and depuffers

Brightening ingredients such as Vitamin C can reduce the appearance of dark circles by inhibiting melanin which causes pigmentation on the surface of skin.  Eye creams with caffeine also can help reduce puffiness and the appearance of undereye bags.  At The Derm Institute one of our favorite eye creams is Neocutis Bio-Restorative Lumiere Eye Cream, which contains caffeine, for depuffing, Vitamin C for brightening, along with PSPs (or Processed Skin Cell Proteins) that harnesses the power of growth factors and cytokines to boost skin thickness.  It is also packed full of anti-oxidants such as green tea extract to firm the skin This is an ideal all in one product for dark undereye circles and is available for purchase at The Derm Institute.


3. Fillers and Peels

One of the most powerful ways to address undereye darkness, circles, and sometimes even puffiness are in-office procedures such as chemical peels and hyaluronic acid injectable fillers.  Products such as Restylane  are sugar molecule gels that can be administered under the eye through a syringe, leaving the undereye area lifted and brightened dramatically. By adding volume back into the undereye, the skin here can be filled in to smooth out any negative contours, effectively eliminating the dark color and shadowing, and erasing the perceived tired look.  Not all dermal fillers can be injected in this area, as have more of a tendency to lump than others.  Placement is also extremely important, as too superficial placement can lead to a bluish visible tint under the skin.  Here at The Derm Institute, Dr. Chiu is an injection instructor, and has extensive experience in addressing this area, including the use of microcannula technique to reduce bruising if necessary.







Physician-grade medium to deep chemical peels including the Phenol Peel can also be used to lift superficial pigmentation, sunspots, address wrinkles and refresh the texture ,

The best part about these procedures is that they can lead to rejuvenation lasting over a year, contact us to find out more!

“Bro•Tox” aka Botox for Men

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1Men 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.

Fillers vs Freezers • Infographic

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Injectable treatments can plump thin lips, enhance shallow contours, soften facial creases, remove wrinkles and improve the appearance of recessed scars. With little to no recovery time and impressive results, injectables are a valuable alternative to more invasive cosmetic surgeries. If you’re considering your first injectable treatment, you may be wondering which is right for you. Learn more about the two main types of injectable treatments available and how they work.


. . . Shared by Dr. Chiu and The Derm Institute Team