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TATTOO REMOVAL [Continued from page 26] ple who have lost their eyebrows due to alopecia (a form of hair loss) may choose to have “eyebrows” tattooed on, while people with vitiligo (a lack of pigmentation in areas of the skin) may try tattooing to help camouflage the condition. Whatever their reason, consumers should be aware of the risks involved in order to make an informed decision and to be aware of the difficulty of removing tattoos once they are applied. The American Academy of Dermatology also reports that tattoo pigments may contain industrial organic pigments, including azo and polycyclic compounds, sandalwood and brazilwood, as well as aluminum, cadium, calcium, copper, iron, phosphorus, silica, sulphur, titanium dioxide, and barium sulphate, each of which may be the cause of a skin reaction like a rash or may be toxic. Home-applied tattoos are often black and carbon based, deriving from India ink, charcoal, soot, and mascara. Most tattoos can be removed, although results may vary depending on the inks used and the depth of the tattoo. Dark blue, red, some lighter blues, and green inks all respond well to laser treatment, but the best candidates for tattoo removal are people with light skin who have a black ink tattoo, according to the AAD. Lasers may be able to remove the tattoo without scarring but may require several treatments. Other options suggested by the AAD include dermabrasion and surgical removal. But Whatever option you wind up going with, the most important choice of all is a qualified individual to perform the removal in the first place. This is your best assurance that you aren’t likely to wind up with a “fix” that’s worse than the original problem was. imAge Deborah S. Sarnoff, M.D., with offices in Manhattan and Greenvale, Long Island, is a pioneer in state-of-the-art cosmetic dermatology, lasers, and Mohs surgery for the treatment of skin cancer. An associate clinical professor of dermatology at New York University Medical Center and vice president of The Skin Cancer Foundation, Dr. Sarnoff has demonstrated her procedures on The Today Show, 20/20, Good Morning America, Dateline and The View. Dr. Sarnoff is co-author of Beauty and the Beam and Instant Beauty: Getting Gorgeous on Your Lunch Break. 60 IMAGE Fall 2008
INJECTABLES [Continued from page 12] few extra days before a big event is a good idea, and avoiding medications that thin the blood is a must. Artefill is a more permanent filler, which can last for several years. It is based on collagen and non-absorbable microspheres. Due to the potential for an allergic reaction to the collagen portion, you will need to undergo skin tests prior to receiving this filler. The advantage, though, is that it lasts a lot longer than other similar fillers because of the non-absorbable microspheres. Another source of filler material is your own fat. Usually the fat is harvested from around the bellybutton area, but other sites can be used. After processing, the fat is positioned under the skin to restore volume in that site. One advantage is that, since you are using your own tissue, there is no possibility of a reaction. It is also permanent, although the “take” is variable, and more than one session may be necessary. The harvesting procedure involves removing the fat through a thin cannula and is, in itself, mildly invasive. As with any procedure, there is a risk of infection. The harvesting and processing add to the complexity of the procedure, so it becomes a little more expensive and a little more involved in terms of “down time” than the other techniques mentioned. There are, of course, other products available, like silicone oil and silicone microspheres. As they are not FDA approved, I do not recommend using these at the moment. Now that you’re familiar with the basic principles, we can progress to the question of where the fillers are most effective. The most common areas are the lines and folds around the lips and nose, and these are the areas that usually are FDA approved for the products. The fillers are placed into the base of the dermis, or just below. Deeper and more established lines may take a bit more filler to get an optimum result. This is where you can use a thicker gel, as well to try to obtain the same result. The lips can be plumped up in this way as well, but they do tend to swell dramatically at first, so it is advisable to allow time for this to settle before public display. The hyaluronic acid-based fillers perform very nicely in this role. Augmentation of the cheeks, chin, and brow areas may be performed on an “off-label” basis, using similar techniques or even injecting the gels in a deeper level. This type of volume augmentation requires more filler and is a bit more uncomfortable than other injections due to this. Some bruising should be expected as well. I like to use longerlasting fillers like Radiesse for this or, alternatively, fat volume augmentation. Artefill is another alternative. So how do you know which is the best filler for you? This is where the consultation comes in. Choices are made based on the area of concern, the extent of correction required, and the duration of the correction. The issue of topical versus local anesthetic injection is also addressed. Due to the viscosity of the gels and the site of injection (like the lip), some form of local anesthesia is a good idea. This makes the procedure a bit more comfortable. A common approach is to use both fillers and Botox in some areas, as they can work together synergistically. Botox does not provide any volume, but by lessening the pull of some muscles on the skin, it can reduce dimples and lines, priming them for a little filler to finish off the job. You can also use a combination of types of filler, for instance in the lips and naso-labial folds. As an overview, the advantage of the injectable fillers and Botox is the ease of administration and minimal downtime. There are few adverse reactions, although a screening process to evaluate specific concerns is sound practice. Costs have been declining with increased use, but again, price is not the only determining factor. More and more practitioners are getting involved with fillers, so make sure you are comfortable with the person whom you choose to perform these procedures on you. IMAGE Fall 2008 IMAGE 61
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FALL 2008 volume one issue one cont
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Dr. Mark Illan Silberman attended D
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PUBLISHER’S letter Welcome! W elc
Page 11 and 12: Fillers and Botox injections are be
Page 13 and 14: The staff of Advanced Laser Medical
Page 16 and 17: IMAGEine This CLARINS HYDRAQUENCH L
Page 18 and 19: B R E A S T A U G M E N T A T I O N
Page 20 and 21: crepancy in firmness between the af
Page 22 and 23: lii: is microdermabrasion the same
Page 24 and 25: T A T T O O R E M O V A L BY CAROLY
Page 26 and 27: The laser beam breaks up the tattoo
Page 28 and 29: H A I R C A R E TO NEW LENGTHS Ever
Page 30 and 31: S P O T L I G H T O N S P A S No La
Page 32 and 33: other senses. When the autumn leave
Page 34 and 35: T E E T H T E C H NEW FRONTIERS IN
Page 36 and 37: Long MEET 6 OF LONG ISLAND’S ToP
Page 38 and 39: John fernbAcker J ohn Fernbacker’
Page 40 and 41: F O R Y O U R E Y E S O N L Y FOUR
Page 42: Wave Scan is cut in the stromal lay
Page 45 and 46: Almost anyone can be a good candida
Page 47 and 48: BY J. NORRIS Looking fresh and natu
Page 49 and 50: nate sagging. She may have also had
Page 51 and 52: LII: So you would say the majority
Page 53 and 54: then the splint is removed. They ma
Page 55 and 56: centing your lips that will never l
Page 57 and 58: Move over, girls…cosmetic surgery
Page 59: improve the recovery time and can r
Page 63 and 64: HAIR EXTENSIONS [Continued from pag
Page 65 and 66: that has been perfected over many d
Page 68 and 69: ADVANCED LASER [Continued from page
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Page 72 and 73: ment or skin flexibility. Coronal s
Page 76: Monday-Thursday MANICURE & PEDICURE
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