Advanced Dermatology, Mohs & Laser Surgery Center, P.A.
240 East Grove St.
Westfield, NJ 07090
P: 908-232-6446/F: 908.232.6447

Botox is used to improve various facial expression lines. Botox is actually a diluted solution of botulinum toxin. When it is injected into specific muscle groups, which cause various facial expression lines, those muscles are temporarily inhibited. The effect lasts four-six months. The inhibition of these muscles results in the softening or resolution of the expression lines. The areas that respond to Botox include frown lines (between the eyebrows), forehead wrinkles, and crow's feet.

The procedure is quite simple. The solution is injected with a tiny needle into various points of the muscle; each area requires 3-5 injections. The results are not immediate but rather take two-seven days to appreciate. Side effects and complications are minimal. Rarely, patients may experience a temporary drooping of the eyelid when the forehead or frown lines are treated. This resolves within 1-2 weeks.
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Perlane is injectable cosmetic dermal filler that has been used to soften wrinkles and facial lines of individuals. It is also a popular filler for lip augmentation, facial depressions, and facial scarring. It can be used in both sexes.

Perlane is made from non-animal stabilized hyaluronic acid gel. Perlane is a non animal product and does not pose any risk of allergies. Hyaluronic acid is a resilient chemical and can easily adjust and mold to the facial contours. Unlike other dermal fillers, no prior skin testing is required prior to the injection of Perlane.

The hyaluronic acid in Perlane augments the body's natural supply, which has become depleted with age. The injected Perlane fills up scars, lines and wrinkles on the face. Perlane is not a permanent product and is broken down in the body. At most, the wrinkle free face remains for about 6-8 months after injection of Perlane. This is a much longer period than any of the currently available temporary dermal fillers.
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Hyaluronic acid is a natural substance found in skin and works to trap water and maintain the intercellular space within the dermis. As our skin ages, hyaluronic acid, collagen and elastin are gradually lost from the dermis. The end result is volume loss, skin laxity, and wrinkles.

Restylane is a non-animal stabilized hyaluronic acid based dermal filler. It was FDA approved for the treatment of wrinkles in December of 2003, but has been widely used in Europe and other parts of the world for many years.

Restylane is produced from streptococcus bacteria. It is purified, sterilized, and then chemically stabilized into a clear gel.

Restylane is used to replenish the dermal volume loss that allows wrinkles to form. It is also used to enhance lips and fill in acne scars. Because it is minimally modified, Restylane has a low incidence of hypersensitivity reactions and requires no skin testing prior to treatment. The chemically stabilized hyaluronic acid found in Restylane can remain in the dermis up to one year. This is significantly longer than the collagen based dermal fillers.

The clear Restylane gel is injected using a fine needle. It is injected into the dermis below the wrinkle and lifts the wrinkle out to the desired correction. Restylane is injected directly into and around the lip for lip enhancements. Topical or local anesthetic is used to anesthetize the injection sites. Mild to moderate stinging and burning is common during the injection, while redness and swelling can last for hours or days after the injection.

Once injected, Restylane integrates into the dermis and binds water. The results are immediate. It does nothing to hinder the normal metabolism and movement of nutrients and oxygen. Over time, Restylane is gradually reabsorbed without a trace. For this reason, follow up treatments are needed to maintain your results at 6 to 12 month intervals.
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Juvéderm is a smooth consistency gel made of hyaluronic acid naturally occurring substance in your skin that helps to add volume and hydration. Dr. Ciatti eases Juvéderm injectable gel under the skin to instantly restore your skin's volume and smooth away facial wrinkles and folds, like your smile lines or parentheses (nasolabial folds the creases that run from the bottom of your nose to the corners of your mouth).

Juvéderm provides a smooth, natural look and feel so everyone will notice (but no one will know)! In fact, studies show superior results of Juvéderm compared to a collagen-based dermal filler."
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Microdermabrasion (particle skin resurfacing)
Microdermabrasion is a unique, revolutionary, new technique used to treat fine wrinkles, sun damage, age spots, scars and acne prone skin. Our office uses the Dermapeel by Dermagenesis, which is one of only two FDA-approved microdermabrasion systems. This technique uses a highly controlled spray of fine aluminum oxide crystals to remove the outer layer of skin and reveal the younger, tighter, and more radiant skin underneath. The treatment takes less than 30 minutes and patients notice improvements in the texture and appearance of the skin almost immediately after the first treatment. There is little pain or discomfort, no recuperative period or downtime (except for a transient slightly pink hue to the treated skin), and all skin types can be treated. For those who experience irritation or redness from chemical peels, this is the perfect alternative.
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Chemical Peels
Chemical peels are used to treat sun (photo) damage, wrinkles, and pigmentation. There are superficial peels such as glycolic peels and medium depth peels such as TCA peels. With glycolic peels the glycolic acid is applied to the skin and then neutralized with water after 2-5 minutes (depending on the tolerance of the patient). Following the peel, the skin is slightly pink. Over the next few days, the pink hue fades, and there may be some superficial peeling, ultimately leaving the skin smoother and softer. It is recommended that at least 3-6 peels are performed for initial effect and then maintenance peels thereafter.

TCA peels are used to address deeper wrinkles and skin pigmentation. These peels are stronger than glycolic peels.  The results are more significant, however, there is more downtime. The skin is left pink-red and scaly for about one week's time. Unlike glycolic peels, make-up is not recommended during that week. The procedure is simple however. The TCA is applied as a mask or liquid to the skin. It self-neutralizes within minutes and is then washed off. TCA peels do not require frequent treatments.
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Sclerotherapy for Leg Veins
Sclerotherapy treatment uses a tiny needle to inject a sclerosing solution, usually hypertonic saline (concentrated salt water) into the dilated veins to be treated. This causes the veins to blanch (turn white) and disappear over time (3-6 weeks). Most patients report minimal discomfort, although the solution can sometimes produce a mild burning sensation, which lasts a few seconds. Most leg veins (spider veins) require 2-3 treatments spaced 3-4 weeks. There is little downtime. The treated areas can appear bruised and mildly swollen for a few days. There may be some pigmentation over the veins treated; this usually resolves in 4-8 weeks.  Laser (refer to Scleroplus pulsed dye laser) can also be used to treat leg veins, although it is reserved for veins that are extremely small (less than 1mm in size).
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