“Triple Effects” Facial Rejuvenation

The Cure for Spring Fever

Get ready for Spring with our exclusive package called “Triple Effects.” Dr. Sandel has combined our most popular treatments to combat the three main characteristics of aging.

  1. Loss of subcutaneous skin volume
  2. Dynamic frown lines and crows feet
  3. Sun damaged skin

What does the Triple Effects package include?

  1. BOTOX® or Dysport™ for up to three areas around the eyes. (Frown, Forehead and Crows Feet)
  2. Two (2) syringes of dermal filler (Restylane®, Juvederm™) to fill the parenthesis and smile lines around the mouth or hollows in the tear trough.
  3. The Active FX Full Face CO2 Laser treatment for improvement of skin tone and texture.  One (1) treatment.

All treatments are performed by Dr. Sandel in a 30 minute office procedure.
Arrive 30 minutes prior to appointment for topical anesthetic application.
No downtime.

Triple Effects Package: $1800
Save over $500 off the regular price if purchased separately

Schedule soon as the appointments fill quickly!
Call 410-266-7120 or schedule online here.


Do You Want Younger Looking Skin?

Experience the “Gentle” CO2 Laser Treatment

*results may vary

The Lumenis Active FX CO2 laser can provide just that! The Active FX procedure is a skin refreshing treatment that makes your skin healthier and younger appearing.

The Active FX procedure is much more gentle than traditional CO2 laser treatments (DeepFX or MaxFX). It can be repeated on a routine basis to keep the skin clean and healthy.

  • Light Surface Treatment with No Downtime
  • Removes Skin Surface Buildup
  • Unclogs and Tightens Pores
  • Smoothes the Skin Surface
  • Treats Brown Spots and Sun Damage

This gentle CO2 laser treatment is performed by Dr. Sandel in the office.  It only requires topical anesthetic cream applied 30 minutes prior to the procedure.  You will see immediate benefits of tighter and smoother skin.

If you have not been getting the benefits you desire from aesthetic facial treatments, microdermabrasion or chemical peels, this is the treatment for you.

Full Face Treatment: $675
Package of 3: $1750

Call today to schedule your Active FX procedure.
No pre-appointment required.
Call 410-266-7120 or email lisa@sandelcenter.com


Why Exfoliate?

Pam Zagula, LE, LPN

Between the ages of 15 and 25 years, healthy skin renews itself about every 21 days.  As we age the rate of cell turnover declines significantly.  Removing dead skin cells naturally stimulates collagen and accelerates cell renewal.  Regular exfoliation improves the skin’s ability to absorb water, serum, lotions, creams or medications. Over time, this will improve skin texture and tone, leaving the skin firm and smooth. Fine lines and wrinkles are diminished and a more even skin color is unveiled.  The cumulative effect of exfoliation leads to improvement in acne, rosacea, and environmental damage.

Whether done at home or professionally, regular exfoliation is a very important step in the cleansing process and is an essential component to all age management and acne control skin care regimes. Virtually everyone needs to exfoliate.

Exfoliation falls into two basic categories – mechanical and chemical.

In my opinion, the best at home mechanical exfoliation is accomplished using the Clairsonic Pro Skin Care system, a great cleanser and the simple act of shaving.

Clairsonic’s sonic vibration and oscillating brush head gently removes 6X more dead skin cells, dirt, oil, and makeup than regular washing.

Shaving with a razor regularly, stimulates collagen and elastin production, removes superficial uneven pigment, as well as keeps your face hair free.

The best professional mechanical exfoliation treatments are Vibraderm, dermaplaning and LASER skin resurfacing.

Vibraderm is crystal and suction free microdermabrasion. A sterile abrasive stainless steel paddle vibrates over the skin surface to efficiently remove dead cells, massage muscle and stimulate tiny vessels that feed the skin. At the cellular level the cell wall becomes more permeable and the cellular channels open for deep penetration of products. Unlike conventional microdermabrasion, the chance of creating new broken blood vessels is not an issue.

Dermaplaning is quite simply, dry skin shaving. The sterile surgical blade gently glides over the surface scraping off surface dead cells, superficial pigment and unwanted hair. Dermaplaning the skin is great prior to or after other treatment modalities such as LED, oxygen, micro-current, Broad Band Light Photorejuvenation, chemical peel, LASER , Vibradermabrasion, antioxidant or medication infusion and will enhance treatment efficacy.

LASER resurfacing is performed with a CO2 LASER. The damaged layers of skin are vaporized with controlled precision. You may require a five to ten day recovery depending on the LASER used, the depth of the peel and your skin’s unique reaction.

Chemical peels stimulate the skin to do just that; peel. The most commonly used chemicals are Alpha Hydroxy Acids, Beta Hydroxy Acids, TriChlorocetic Acid, Retinoic Acid and Fruit enzymes. Most chemical peels will cause the skin to shed three to five days after application. Some may leave you peeling five to fourteen days after. The type of chemical, its potency and your skin’s unique reaction determines your post peel recovery time.

No matter how you choose to exfoliate, the goal is to restore skin health and beauty. The accumulation of home and in office treatments will absolutely assist you in your desired result. Healthy skin is beautiful.

Remember to always apply an appropriate moisturizer, sunscreen and practice sun safety.


Injectable Fillers: What is the difference?

BOTOX, Dysport and Injectable Fillers are becoming more popular these days!  As explained in a recent article in The Capital newspaper featuring Dr. Sandel, the economy is pushing many patients towards less costly and less invasive procedures.  These treatments, although temporary, can really help improve your appearance before you decide to invest in facial rejuvenation surgery.

There are many different types of injectable fillers.  The most common being those containing hyaluronic acid.  Hyaluronic acid is a naturally occurring sugar that is used to plump fine lines and deep skin creases.  This gel takes a long time to be absorbed in the skin, thus allowing the filler to maintain volume for as long as 12 months.

Restylane was one of the first hyaluronic acid fillers introduced in the U.S.  There are now other products such as Juvederm Ultra, Juvederm Ultra Plus, and Perlane.  The difference in these products is in the concentration of hyaluronic acid.  Juvederm Ultra is the least concentrated making it thinner than the others.  Perlane and Juvederm UltraPlus are much more concentrated.  Restylane is somewhere in the middle.

So, what difference does this make?

Restylane, which comes in 1ml and 2ml syringes, is a great all around filler.  Dr. Sandel prefers Restylane for the cheek-lip grooves and downturned corners of the mouth.  It gives the perfect amount of volume for these deeper, harder to fill grooves.  Perlane, though a little more concentrated, is very soft and holds its shape well.  This is primarily used for defining the borders of the lips.  Perlane is excellent at giving the lips just the right amount of definition, volume and shape.  Juvederm, the thinnest of these fillers, is primarily used for very fine lines around the mouth.  Juvederm can be placed close to the surface of the skin without being noticable.


Kindly erase the appearance of wrinkles

Pam Zagula, LE, LPN

Have you ever stopped to think about the products you are applying to your face, neck and chest? Are you curious about the active ingredients?  What are they and why are they so special?  There are so many products on the market - it’s mind-boggling.  Even for me, the skin professional.  So in my attempt to educate my self, I feel compelled to educate you.

This month I investigated Kinerase Pro+Therapy.  As most of you know I’ve been in the business for a long time.  In 1998 Kinerase was introduced to me as a product I could incorporate into an existing skincare regime.  A product that will produce Retin A like results with out the redness, irritation and peeling that many experience in the initial phases of a retinoid based home care program.

The magical ingredient, Kinetin also known as N6-furfuryladenine, is derived from plant based RNA.  Kinetin is a powerful anti-aging plant hormone that has the ability to protect and repair DNA and proteins from oxidative damage caused by free radicals.  I love this product because it works.

When the original Kinerase went over-the-counter in 2006, Kinerase Pro +Therapy was born and made available to the medical aesthetician.

So how is Kinerase Pro+therapy different? They added another plant hormone called Zeatin.  Studies have shown the combination of these two powerhouse plant hormones increase the skin’s ability to retain moisture within the cells leaving the skin firmer, plumper and more youthful.  You will notice improved appearance of fine lines and wrinkles, skin roughness and hyperpigmentation.  There are many other ingredients enhancing the anti-aging benefits of this wonderful product line such as Antarcticine.  This ingredient protects and regenerates skin by enhancing the production of collagen and elastin, and increases the skin’s moisture content.  It is a very powerful anti-wrinkle glycoprotein obtained via biotechnology from a bacteria strain found on the bottom of an Antarctic glacier.  The Pro+Therapy line also features ingredients such as Vitamin C, E, green tea (to fight free radicals), salicylic acid, lactic acid (to aid in exfoliation), and beta glucan (to enhance the skin’s immune response) just to name a few.  The use of these products daily will prevent and repair damage, taking your skin to the next level.  “Healthy skin is beautiful.”


Dermaplaning

Pam Zagula, LE, LPN

I have learned so many remarkable things from the incredible women that come to me for my expertise. They share their life experiences with me and I am so grateful for their trust. I am going to share with you why I incorporate dermaplaning into my health and wellness plan for my skin and the skin of my clients. Early in my career I was in consultation with a very beautiful woman I thought to be in her early 50’s. She had not revealed her birthdate during consultation, as many choose not to. As I was explaining dermaplaning to her, she politely listened, then shared with me her secret. To my surprise she was not in her early 50’s. She was 65.  Clearly, she appeared to me to be 10 years younger than her chronological age. She continued to reveal that, while living in Japan, she was introduced to facial shaving. She shared with me the barely known fact; Japanese women shave their face regularly and, historically, have done so since the 16th century. To my surprise, she had been shaving her face daily for twenty years. Her skin was delicate and had exquisite texture and color.  She was delighted with the idea of having her face dry shaved professionally.

Christina Carlino, a mentor, friend and the past CEO of Biomedic Clinical Care, now La Roche Posey, introduced me to dermaplaning in 1991. Dermaplaning is the third step in Biomedic’s trademarked Micropeel.

 As I researched this topic on line, I found that there were several other names for this technique; “Clinical Skin Resurfacing Facial Exfoliation” and “Razor Facial.” I know it simply as dermaplaning.

Dermaplaning is a mechanical exfoliation as opposed to using chemicals or lasers.  With the steady hand of a trained practitioner, a sterile # 10 - Teflon coated surgical steel blade is attached to a # 3 knife handle.  It is held by the practitioner at a 45-degree angle and then the magic begins.  The guided blade gently scrapes across the skin’s dry surface removing dead skin cells, superficial pigmentation and unwanted facial hair.

In a clinical environment, dermaplaning is a very effective procedure by itself or can be combined with other modalities such as Vibradermabrasion, acid peels, BBL, LASER, LED and others in order to enhance efficacy.  Stripping away the dead, uneven stratum corneum from the epidermis removes the barrier and allows for maximum penetration of active ingredients.  Dermaplaning promotes cellular turnover and stimulates collagen and elastin. Immediately post-treatment the skin feels smooth, appears luminous, fine lines seem to disappear and make up glides on with ease.

Contrary to what many believe, dermaplaning does not encourage the abnormal growth of hair.  If the hair is soft, light and furry it will not grow back thick, coarse and dark.

For the past 19 years I have been shaving my face and the faces of those who seek my expertise. I will continue to offer this treatment for many years to come.


New competition for BOTOX®

Look out BOTOX®!  Your competition for wrinkle reduction in the United States has finally arrived.  After years of clinical trials in the U.S. and many more years of clinical use and experience overseas, Dysport® has recently received FDA approval. 

For the past 7 years, BOTOX® (botulinum toxin type A, Allergan, Inc.) has been the only choice for injectable wrinkle correction of frown lines around the eyes and forehead.  That changed last month when Dysport® (botulinum toxin type A-hemagglutinin complex, Medicis) received FDA approval in the United States.  

How does Dysport® work?
BOTOX® and Dysport® are injectable medications that are comprised of proteins derived from the bacteria Clostridium botulinum that produces botulinum toxin.  These proteins are absorbed into the neuromuscular junction and cause a local paralysis at the site of the injection.  Many of the lines and wrinkles that form around the eyes and on the forehead are caused by muscle action on the skin.  Reducing this muscle action by injecting this protein is extremely effective at reducing these fine lines and wrinkles for a certain length of time.
Is Dysport® more effective than BOTOX®?
There have been mixed reports regarding the clinical response to Dysport® versus BOTOX®.  It is understood that Dysport® has about one-third the potency of BOTOX® and therefore requires more of it to be delivered to the site of action.  However, many practitioners have noticed that when using a similar concentration of Dysport®, there is a longer duration of action.  Some clinicians have noticed that Dysport® may last up to 1 month longer than BOTOX®.
This may, however, come at a price.   There have been reports that suggest a tendency for the medication to travel farther from the injection site when compared to its competitor.  This may be good when treating forehead lines, where a broader treatment is needed.  But it can be a detriment when trying to treat specific areas around the eyes.  If the product travels too far in these areas, there may be a higher incidence of eyebrow ptosis or droop.  However, the incidence of eyebrow droop is no higher than BOTOX® in large clinical trials, and, in fact, may be a little lower!
What is the difference in price?
While competition in the market place is generally good for reducing prices, it is unlikely we will see a drop in prices when the use of Dysport® becomes more widespread.  At this time, it does not look like the cost of Dysport® to the physician will be much less than the cost of BOTOX®.  The cost to the patient remains to be seen.
When will Dysport® become available?
We can expect Medicis, the manufacturer of Dysport®, to start making this medication widely available to cosmetic surgeons and dermatologists in the fall.

Rhinoplasty and Nasal Breathing Disorders

Are you one of the many people who would like to make a change in the appearance of your nose?  

Perhaps you are happy with your appearance but would like to be able to breathe better?  Both of these aspects of the nose can be addressed with a relatively simple procedure called a rhinoplasty.

rhinoplasty, or nose surgery, is a specialized procedure performed by facial plastic surgeons.  Usually done under anesthesia, the surgeon can make many changes to the shape and function of the nose.  Some of the problems that can be addressed include removing a “hump” on the top of the nose, refining the shape of the tip or ball of the nose, making the nose smaller as a whole, or even opening the breathing passages to allow more airflow into the nostrils.  

How are these changes made?

The first stage of a rhinoplasty usually involves the nasal septum.  This is a thin piece of cartilage that separates the right  and left sides of the nose.  Commonly referred to as a septoplasty, this piece of cartilage is removed or straightened.  If the septum is deviated causing difficulty breathing, this maneuver will help.  Also, part of this septum is harvested in order to refine or make changes to the outer shape of the nose.

 

The next stage is to remove the hump by softening the nasal bone.  Sometimes in order to remove the hump and make the nose less wide, the nasal bones need to be moved inward.  This may require the surgeon to precisely break the bones so that they heal in a more desirable position.

Once the upper portion is finished, the tip can be addressed.  This is where surgical experience and expertise is of the utmost importance.  Refining the shape of the nasal tip and making the nose look smaller in the lower portion requires very fine techniques.  When performed correctly, the nose looks very natural and softer in appearance.

Does insurance cover the cost of a rhinoplasty?

Yes.  If you have difficulty breathing, then insurance will cover the procedures that help you breathe better.  This can be a significant portion of most rhinoplasty procedures.  If you desire an improved appearance, you would be responsible for that portion of the surgery.


Winter Weather Skincare

by Pam Zagula, LE, LPN (Advanced Medical Aesthetics)

The cold winter weather is here. It won’t be long before low humidity, cool temperatures, wind, and indoor heat take its toll and cause the skin to become dry, chapped, and flaky, which will cause the skin to look pale and dull, accentuating lines and wrinkles. It may feel rough and itch. Certain skin conditions such as eczema, psoriasis and rosacea may worsen.

There are many things you can do to lessen the wrath of winter weather on your skin. 

·         Drink plenty of water

·         Consume caffeine and alcohol in moderation

·         Eat a diet rich in Essential Fatty Acids

o   EFA’s are found in whole grains, nuts, seeds, olives, avocados, cold pressed oils, and cold- water fish such as wild salmon.

·         A vaporizer or humidifier in the bedroom

o   This helps to reestablish the moisture levels in the respiratory tract and eyes as well as the epidermal layers of the skin.

·         Baths and showers should be warm, not hot and of short duration.

o   When taking a bath, bath oils can be added to bath water to help further moisturize the body.

o   Body oils, lotions and creams should be applied directly to the skin immediately after the bath or shower.

·         Have regular professional skincare treatments.

o   Gently removing the dead surface layer (with a Vibraderm treatment) increases product penetration and improves the skins ability to better absorb topically applied products.

o   Oxygen therapy treatments are incredibly moisturizing and soothing after a professional exfoliation.

o   LED light as well as micro-current treatments gently encourage cell turn over, stimulate collagen synthesis, as well as aid in product penetration.

o   Medications, specialty products may be indicated.

o   Treatments such as broadband light (IPL) will help eliminate exacerbations of Rosacea, broken blood vessels and brown discolorations.

Don’t be fooled by the colder weather, the sun is still a danger to all exposed skin. It is especially important to remember during times of play and enjoyment of wintertime sports the sun’s light intensifies as it reflects off snow. Add low humidity, wind and high altitudes and you can get a whopping sun/wind burn. Cover as much exposed skin as possible and don’t forget to use sun block!

Flying somewhere this winter? 

Before the flight, cleanse the skin and use a mild scrub followed by an appropriate moisturizer.

 During the flight, spritz the face with mineral water frequently, drink 8 ounces of water for every hour in flight, and avoid alcoholic and caffeinated beverages, as they are very dehydrating.  Moisturizing eye drops help to prevent dry, scratchy eyes and using a lip ointment will help to avoid dry, cracked lips.

Your aesthetician is an expert in helping you choose appropriate treatments in the treatment room and will assist you in choosing the appropriate after treatment home care. Products containing growth factors, DNA repair enzymes, retinaldehyde, alpha hydroxy acids, ferulic acid, urea, hyaluronic acid, vitamins A, C, and E will assist you and support healthy winter skin.

HEALTHY SKIN IS BEAUTIFUL!


The Face of Health Series - Laser Skin Rejuvenation

Traditional Laser Treatments

Lasers have been used for rejuvenating the skin for many years. Traditional treatments have included chemical peels and carbon dioxide lasers (CO2). These treatments are excellent in providing dramatic results with one treatment session. Patients who are selected appropriately with regard to their skin types can benefit from the marked reduction of fine lines, wrinkles, sun spots, discolorations, uneven skin texture, and scarring. Although technology has come a long way, nothing has matched the efficacy of these traditional modalities.

However, the CO2 laser and chemical peels have several risks associated with them that make them difficult to use in untrained hands. Some of these include pigmentation changes, lines of demarcation, redness, long recovery periods and, in rare cases, scar formation. It is important to select a facial surgeon who is highly experienced with these techniques to avoid or minimize these complications.

Exciting New Laser Technology

As laser technology has evolved over the past 5-10 years, exciting new modalities have become available. The latest laser technology uses fractionated patterns of ablation which allow the skin to heal much faster than traditional full ablative resurfacing. There is also much less risk of developing lines of demarcation or prolonged redness. The fractionated laser works by creating small microscopic pinholes in the skin while leaving some normal tissue in between. As the deep collagen layer heals, the skin becomes more firm and youthful and fine lines disappear. Sun spots and pigmented areas are also improved dramatically improved.

Although not quite as effective as the traditional CO2 laser or chemical peels, these new lasers offer outstanding results over one to three treatment sessions, each with little to no downtime. Even the more aggressive resurfacing procedures will heal almost completely in less than 5-7 days. These procedures can be performed in an office setting without requiring sedation. Topical numbing cream is usually sufficient.
It is important that you discuss your concerns with your facial plastic surgeon so that a precise treatment plan can be formulated. Your surgeon should give you detailed information about the specific laser treatment being offered including the risks and benefits associated with it. After the procedure, you should be seen about every other day for the first week to ensure optimized and rapid healing.


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