Within hours of being injected, the BOTOX^® protein enters the nerve endings that stimulate the muscles. After several days, BOTOX^® prevents the release of a substance called acetylcholine at the neuromuscular junction which signals muscle contraction. This is a temporary condition which reverses after the effect of BOTOX^® wears off. Sensory nerve endings are not negatively affected so there is no numbness or abnormal sensation in the area treated.

• Frown lines
• Creases between the eyebrows
• Horizontal forehead lines
• Crow’s feet
• Upper lip winkles (“smokers’ lines”) can be lessened
• Dimpling on the chin
• Poorly defined jaw line
• Drooping of corners of the mouth
• Lines on the neck – thick vertical cords and horizontal “necklace lines”
• Lines between the breasts

People with rare neurological disorders such as myasthenia gravis and those who have Eaton-Lambert syndrome should not be treated. Women who are pregnant or are breast feeding should not be treated, nor should those with an allergy to albumin or penicillamine.

You will be asked to fill out a brief medical history and you will have a discussion with Dr. Rosenthal regarding the areas to be treated. Photos will be taken and the treatment area will be cleansed before the injections. Ice will be applied prior to injection and immediately after.

10 – 30 minutes depending on the number of injections. You can return to work or other activities immediately after.

Most people can walk out without any visible signs of having been treated, unless a small bruise develops.

Most people find it almost painless since very tiny needles are used. No anaesthetic is required, but the skin may be pre-cooled prior to injection. All injections are done by Dr. Rosenthal.

The treatment allows for natural movement and the effect starts after 1 – 5 days and peaks in about 2 – 4 weeks. The results can last 3 – 6 months or longer. After which the effect can gradually wear off allowing the wrinkles to return, unless another BOTOX^® treatment is done. When it is used to combat excessive sweating it usually lasts 8 – 12 months. Higher doses may last longer and with repeated treatments the duration of the effect may be increased.

There are usually no permanent problems or side effects. Temporary side effects include occasional bruising at the injection site and when the eyebrows are treated eyelid droop very occasionally occurs. Eyelid droop can last 2 -4 weeks and can be treated with special eye drops.

There are usually no long-term side effects, allergic reactions, or other health hazards. When the muscles are relaxed the lack of movement (frowning) prevents disruption of the collagen alignment and the skin remains smoother longer. Some patients have been receiving BOTOX^® injections for more than 10 years without problems.

BOTOX relaxes the muscles which cause many facial lines and unwanted facial expressions. We use fillers such as Restylane^®, Juvederm^®, Teosyal^® for lip enhancement, to eliminate creases and lines, restore volume in the cheeks and to correct defects including acne scarring. Sometimes BOTOX is used in combination with fillers – for example when treating deep frown lines or wrinkles around the lips.

BOTOX can also be used in conjunction with chemical peels, laser therapy, injection of fillers and cosmetic surgery to prevent or delay the development of new wrinkles and the need for repeat treatments.

The uses of BOTOX^® can in some cases delay or eliminate the need for a surgical procedure (facelift, brow lift or neck lift). If you have had a face lift, BOTOX^® can prolong and enhance the benefits of surgery by reducing the muscle activity that might undo the surgeon’s fine work.

Not all facial wrinkles and folds are related to the activity of the underlying muscles. These deep creases and skin folds are the ones still visible when the skin is lightly stretched with your fingers. These ‘static’ wrinkles are made worse by sun exposure, the natural aging or maturing process and by smoking but they can be helped by the use of fillers and other available treatments such as Laser Genesis, and Titan, eCO2 and Mosaic fractional lasers and Pearl.

Face at rest before Botox

Face at rest after Botox

Face frowning before Botox

Face frowning after Botox

Face before and after Botox cosmetic treatment.

Crow's Feet before Botox

Crow's Feet after Botox

Before Botox and Filler

After Botox and Filler

Before Botox and Filler

2 Weeks After Botox and Filler

Before Botox and Filler

After Botox and Filler

Before Botox Cheek Reduction

After Botox Cheek Reduction

It takes about an hour after the topical anaesthetic is put on.

All eCO2 Fractional Laser treatments are done by Dr. Gillian Rosenthal with the assistance of a laser technician.

Prior to the treatment we will take every step to ensure that you are comfortable during the procedure. We take extra care to ensure that you will be comfortable during the treatment and afterwards. We will provide you with post-treatment care instructions.

We do not give these treatments without a consultation with Dr.Rosenthal. She will carefully examine your skin to determine if this is the best treatment to achieve your goals. Alternative treatment options will be outlined. If you decide to have the eCO2 treatment you will then be given pre-treatment instructions and also be made aware of the post-treatment procedures.

You will look red and swollen. By the 5th day post treatment the swelling will have diminished and the redness minimized. After 72 hours you can apply makeup to minimize the redness. Many clients arrange their eCO2 treatment for a Thursday or Friday to minimize the potential of time off work. The post-treatment care that we advise will help to minimize the symptoms and as part of the treatment we will book an appointment for you to return after a few days so that we may monitor your progress.

After about a week you will see changes that will continue to be enhanced over the next 6 months. You should within a week feel that your facial skin is tighter, that the surface is smoother and that wrinkles and sun damage have either gone or been minimized. The timing and extent of the results is totally dependent on the individual being treated, the extent of the treatment that was done and the following of our after care instructions.

http://www.youtube.com/watch?v=Xaq2omkqNNQ
or for acne sufferers
http://www.youtube.com/user/lasermania8

Photos courtesy of J. David Holcomb, M.D.

eco2 single treatment
Photos courtesy of J. David Holcomb, M.D.

Before and after eco2

Rejuvenation using eco2 Laser

Photos courtesy of J. David Holcomb, M.D.

Before eCO2 acne treatment

after eCO2 acne treatment

Before eCO2 and Soft Lift treatment

after eCO2 and Soft Lift treatment

Before MOSAIC and eCO2 treatment

after MOSAIC and eCO2 treatment

Before eCO2 treatment

after eCO2 treatment

On average, each treatment takes about 45 minutes.

Previously the Injection of fillers required the use of either a topical numbing cream or injection of a local anaesthetic to make the procedure more comfortable. Now the filler is pre-mixed with anaesthetic (freezing) to ensure that the procedure is comfortable. Filler is injected, using a tiny needle, into each target area.

The side effects can include localized temporary bruising and swelling, both of which can be reduced by the use of cooling before and after treatment. Prior to the procedure, Dr. Rosenthal will discuss the process and side effects. At that time you may ask any questions that you may have.

Studies have shown that hyaluronic acid fillers can last 9 – 12 months. They tend to last longer when they are injected deeper into the skin to restore volume. In these situations, although a small “top up” may be needed after one year but the treatment can be very durable- lasting several years. For lip rejuvenation and enhancement and in the treatment of areas subject to considerable movement of muscles the effect lasts for a shorter period but can be enhanced by combining the filler with a BOTOX treatment.

Sculptra^® can last more than 2 years, and Radiesse^® can last over 1 year.

You will be able to immediately appreciate the effect of the filler. There may be mild redness and minor bruising but this should quickly resolve.

Results are instantaneous.

Hyaluronic acid (HA) is made in the laboratory by a bacterial fermentation process. It is highly purified material and hence allergic reactions rarely occur. Pre-testing is not required. As HA represents a durable form of a natural constituent of the skin and other parts of our body, it is very well tolerated and readily incorporated into the surrounding tissues. HA can provide a very natural smooth appearance to the skin. Radiesse^® has been used medically for many years and is extremely safe and biocompatible.

Mild bruising which can be minimized through the use of cooling before and after the procedure. There can be transient redness, swelling, itching or discomfort and with lip injections the swelling can last for longer periods. If you have suffered from cold sores, antiviral medication will be provided to prevent cold sores from breaking out in the treatment area. The use of fillers should be deferred if your skin is actively infected, or if you are pregnant or breast feeding.

Before Filler treatment

After Filler treatment

Before Filler treatment

After Filler treatment

Before Filler treatment

After Filler treatment

Before Filler treatment

After Filler treatment

Before Filler treatment

After Filler treatment

Before Filler treatment

After Filler treatment

Before Filler treatment

After Filler treatment

Before Filler treatment

After Filler treatment

Before Filler treatment

After Filler treatment

Before Non-Surgical Lift and eCO2

After Non-Surgical Lift and eCO2

Before Botox and Filler

After Botox and Filler

Before Botox and Filler

2 Weeks After Botox and Filler

Before Botox and Filler

After Botox and Filler

Before Lip Enhancement and Non-Surgical Face Lift

After Lip Enhancement and Non-Surgical Face Lift

Before Non-Surgical Lift

After Non-Surgical Lift

Before Lip Enhancement and Non-Surgical Lift

After Lip Enhancement and Non-Surgical Lift

It takes about an hour after the topical anaesthetic is put on.

Prior to the treatment you will receive treatment to ensure that you are not uncomfortable during the laser procedure. Typically all that is needed is topical numbing crème and ibuprofen. We take extra care to ensure that you will be comfortable during the treatment and afterwards. We will provide you with post-treatment care instructions and will also schedule a follow up visit to chart your progress.

After your first treatment you may see a very positive change, but for best longer lasting results you will require about 3 treatments. In the case of deep acne scarring you may require 5 treatments.

You can have treatment on the face, neck, décolleté, hands, arms, abdomen and scars – on most places.

Your facial appearance will be red and swollen – somewhat like sunburn. This can be covered with make-up. You can return to you regular routine or work the next day. Within 48 hours your skin will undergo ‘bronzing’ and there will be shedding of flakes. When this is completed your skin will be smooth and glowing. The changes are completely natural and while you may receive remarks about how good your skin looks, there will be no evidence that a laser procedure has been done other than an improvement in your appearance. The collagen production that is stimulated by the treatment continues for 6 -12 months, so you will continue to see additional subtle changes.

Before Mosaic to treat surgical scars

After Mosaic to treat surgical scars

Before Mosaic treatment

After 4 Mosaic treatments

Before Mosaic treatment

After Mosaic treatment for skin tightening

Before Mosaic treatment

After Mosaic to improve skin texture

Pearl will smooth the skin’s texture, as well as soften fine lines and wrinkles, on the face, neck, upper chest and hands.

The treatment takes approximately 10-15 minutes for a full face. The treatment feels like a series of brief pinches.

Downtime is the time spent recovering from a procedure. With “social” downtime, you can continue your normal daily activities. However, you may not wish to attend important social events because after a Pearl treatment your face will appear pink/red for 3-4 days.

Patients of any age with sun damage, uneven skin texture and fine lines and wrinkles can benefit from Pearl treatments; however, the most common age group seeking treatment is 25-60.

After treatment, the skin will look like it is sunburned. Ointment will be applied on the skin to keep it moist. The skin will need to be kept moist for 3–4 days. Since you cannot wear sunscreen during this time, you will need to wear protective clothing and limit sun exposure for a few days following the treatment. You are free to wear make-up starting on day 3. After 3-4 days, the top layer of skin peels off revealing new, healthy, vibrant skin underneath.

Many patients experience excellent results after one treatment. Others may want a second treatment for best results.

You will see noticeable results on day 3 or 4, when the superficial tissue has peeled off, leaving fresh, new, healthy skin underneath.

Pearl offers the most effective treatment to address fine lines & wrinkles, sun damaged skin and uneven texture without wound care and the extended downtime required with traditional Erbium and CO2 laser procedures.

Today’s fractionated technologies treat only small portions of the face during each treatment. Typically, 3 treatments, each with 4-6 days of downtime and spaced a month apart, are required to treat the face.

Yes, FDA clearance was received in March 2007 for Pearl for skin resurfacing and the treatment of wrinkles. Pearl is used primarily on the face but has also been used on the neck, upper chest and hands.

Before Pearl^® procedure
Photos courtesy of Maritza Perez, MD<

After Pearl^® procedure
Photos courtesy of Maritza Perez, MD

Before Pearl^® procedure
Photos courtesy of Maritza Perez, MD

After Pearl^® procedure
Photos courtesy of Maritza Perez, MD

Before Pearl^® procedure
Photos courtesy of Maritza Perez, MD

After Pearl^® procedure
Photos courtesy of Maritza Perez, MD

Before Pearl^® procedure
Photos courtesy of Leonardo Rasi, MD

After Pearl^® procedure
Photos courtesy of Leonardo Rasi, MD

Before Pearl^® procedure
Photos courtesy of Amy Foreman Taub, MD

After Pearl^® procedure
Photos courtesy of Amy Foreman Taub, MD

Before Pearl^® procedure

After Pearl^® procedure

Care will be taken to ensure that you will be comfortable and that pain is almost non-existent when performing Soft Lift. BOTOX^® injections are usually done without any numbing gel and are described as “only a short pinching of the skin”. Fillers that are combined with local anaesthetic are used after the application of numbing gel and the majority of our clients find the procedure to be pain-free.

For most clients they simply return to their normal activities. We advise against vigorous activity within 3 weeks of BOTOX^® injection and we recommend that for 3 nights that you do not sleep on your sides to avoid displacing the product. You may receive other instructions as to post-treatment care.

Soft Lift procedures can sometimes produce minor amounts of bruising. If this happens we can apply either your makeup or our own line of mineral makeup. The bruising usually goes away within a week. Swelling can also occur and while typical the swelling is usually modest and quickly recedes.

Soft Lift will last a considerable time but it is not permanent. The fillers used can last for up to a year – dependent on the treatment location. At that time a “top up” can be done. This usually required only a fraction of the amount of the product previously injected.

It has been noted that usually the implant is very stable after the second injection and may not need further treatment for a long period of time. The BOTOX^® may have a shorter duration but the treatment can easily be repeated.

Before Soft Lift treatment

After Soft Lift treatment

Before Soft Lift treatment

After Soft Lift treatment

Before Soft Lift treatment

After Soft Lift treatment

Before Soft Lift treatment

After Soft Lift treatment

Before eCO2 and Soft Lift treatment

after eCO2 and Soft Lift treatment

Before Soft Lift treatment

After Soft Lift treatment

Before Soft Lift treatment

After Soft Lift treatment

Before Correction of Downturned mouth Using Juvederm™ Filler

After Correction of Downturned mouth Using Juvederm™ Filler