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When it comes to improving dull skin, rough texture, hyperpigmentation, and acne, chemical peels and lasers remain the gold standard. Both help to reduce the appearance of pores and soften fine lines. Both entail relatively minimal downtime (a few days of redness, swelling, and peeling). And both can be exceptionally effective—in the right situations. Here, I’ll help you pin down which treatment is right for you.

How do they work?

First, let’s take a closer look at each treatment. A chemical peel uses various acids, such as lactic, salicylic, or trichloroacetic (TCA), to resurface the skin and remove surface pigmentation.

Which treatment is right for me?

Regardless of your skin type or the issue you want to address, both peels and lasers will require multiple treatments in order to achieve the best results. The total number can be as few as two, but it’s generally between three and six. 

With that in mind, if given a choice, a chemical peel is the better option if you’re on a budget. Its price depends on the strength and concentration of the peel, but the range is typically less than that of a fractionated laser treatment.

Both types of treatments can provide you with more radiant skin, though, if you have dark skin and you opt for a lower-energy fractionated laser, like Clear + Brilliant, you’ll want to make sure the treatment is done by someone who has a lot of experience using this laser on dark skin types. It’s considered safer than a stronger laser resurfacing procedure, but the results can vary in under-experienced hands.

For the most part, however, a chemical peel is the safer means to resurface and tighten dark skin. The heat of a fractionated laser can contribute to hyperpigmentation. (For everyone else, a laser is the clear choice for skin-tightening. The heat will spur the production of natural collagen and elastin, the basic building blocks of firmer skin.)

Some plastic surgeons will start with a peel and move to a laser if the results aren’t meeting their expectations. In those instances, they’ll use a lower-energy fractionated laser at low strength over a few treatments in order to avoid post-inflammatory hyperpigmentation.

A similar approach is often used when aiming to erase persistent patches of acne. A series of salicylic acid peels exfoliate the skin and penetrate the pores to unclog them. At which point, a long-pulse laser can shut down overactive sebaceous glands. It’s safe for dark skin because it won’t burn the upper layers.

If you want to learn more about our med-spa services and chemical peels. please contact us at info@daviscps.com and our team will be happy to help you and schedule a virtual consultation.

Here at Davis Cosmetic Plastic Surgery we do not lump Injectables into one big pile, even though their qualities and uses can vary significantly. One in particular that stands out for us is Sculptra because it’s made of poly-L-lactic acid (rather than hyaluronic acid) and it works with your body to regrow collagen, which is unique among wrinkle treatments.

Sculptra is approved by the FDA for filling wrinkles and reducing hollow, sunken cheeks and temples. Because it tasks your body with making collagen, it can take longer to see results than it does with hyaluronic acid fillers, but the effects will last much longer. Which also means that, as a side benefit, Sculptra tends to be less expensive overall than hyaluronic fillers for patients who need a lot of volume replenished.

“When applied correctly, Sculptra looks positively natural,” says Dr. Steven Davis. This is why it’s imperceptible. “Since it is slowly and steadily building support for your skin, no one would ever be able to tell you’ve had it injected.”

What’s the treatment like?

Sculptra injections are similar to just about every other kind of filler injection. There may be some mild discomfort, which can be mitigated with a topical numbing agent. After the injections are completed, your plastic surgeon will massage your face for a few minutes, to ensure the Sculptra is distributed evenly among the targeted areas.

Following the procedure, some mild swelling, bruising, and soreness around the injection sites is normal. But all of that should clear up fairly quickly. In the meantime, it shouldn’t be anything significant enough to keep you from your regular activities.

When will I see the results?

Most patients of DCPS tend to look great right after injections. But, gradually, those effects will wear off. And after a couple of days, you should look much like you did before the treatment. That doesn’t mean the treatment didn’t take. All the while, your skin is using the poly-L-lactic acid to produce new, natural collagen.

You should begin to notice a difference within a week or two of your treatment. Usually, it’ll take between four to eight weeks to see the full effects of your injections. And while that may sound like an eternity, consider the bigger picture: Those results will last for two to three years. 

If you’re on the fence about a facelift, Sculptra may prove to be the perfect bridge. Please consult the team at Davis Cosmetic Plastic Surgery for a consultation, or if you have any questions.

Facial rejuvenation procedures continue to be the fastest-growing segment of cosmetic plastic surgery, and botulinum toxin type A injections are one of the biggest reasons why. Last year, close to 7.7 million of them were done in the United States, which set a new annual high, according to the American Society of Plastic Surgeons.

(Dermal fillers were second on the list of most-performed cosmetic procedures last year, at 2.7 million.)

You’re probably more familiar with the different brand names of botulinum toxin type A: Dysport, Xeomin, Jeuveau, and, of course, Botox. While there are subtle differences between them, they all work the same way, essentially. 

In order for any muscle to contract, the nerves release a chemical messenger called acetylcholine at the point where nerve endings meet muscle cells. Acetylcholine attaches to receptors on the muscle cells and causes the cells to contract, or shorten.

Botulinum toxin type A injections prevent the release of acetylcholine, which stops the muscle cells from contracting. Basically, they temporarily put the muscles to rest, which helps the muscle become less stiff. In the process, they also temporarily minimize or eliminate altogether creases and fine lines that stem from the constant contraction of those muscles, like forehead wrinkles, crow’s feet, and the dreaded “11” between the eyebrows.

Which one is right for you?

Without getting too technical, a board-certified plastic surgeon distinguishes between the brands based on subtle but significant differences, like how much it will spread after it’s injected. 

First, they’ll want to hear all about your expectations for the procedure. They’ll then be able to select the botulinum toxin type A that’s best suited for that particular area of the face and the desired outcome.

Much of the outcome, however, will come down to the injector. For example, the pressure that’s used to inject the botulinum toxin type A can have a big impact on the results. Also key is the injector’s knowledge of the muscles in the targeted area. It may seem fairly straightforward—rest the muscle, the lines disappear—but the human body is a series of intricate, interconnected networks.

In other words, for every action, expect a reaction.

Case in point: In order to lift the forehead, botulinum toxin type A should be injected into the depressor muscles around the brow, because they’re the ones working to pull the brow (and forehead) down. But simply injecting those muscles isn’t enough. The injections need to be precise because if they land in the wrong parts of the depressor muscles, the botulinum toxin could seep into the frontalis muscle, which lifts the forehead. 

The result in that scenario is an even heavier-looking brow than what the patient started with. And it’s surprisingly common.

Expertise matters most

I have extensive experience with doing botulinum toxin type A injections. Even more, I train plastic surgeons, dermatologists, and nurses across the country on behalf of all of the aforementioned brands in how to use them appropriately and accurately.

I’m convinced of their value in creating a younger, more vibrant appearance. But I also know that those results depend more on who’s doing the injecting than which brand is being injected.

If you would like to discuss your options, my team at Davis Cosmetic Plastic Surgery is available to answer questions and schedule your virtual consultation.

Davis Cosmetic Plastic Surgery finds facelifts to be quite nuanced. The countless buzzwords used to reference them do not add any clarity to the subtle differences between the procedures. Though, DCPS noticed one in particular seems to be drawing most of the attention this summer: the so-called “ponytail facelift.”

The name stems from the lift’s effects, which are meant to mimic that of pulling one’s hair back into a tight, high ponytail, drawing the skin of the scalp and, in turn, the forehead, cheeks, and brows upward in order to create a more youthful appearance.

Because all of that is accomplished without the traditional scars of a facelift, the name is also apparently a nod to the fact that the patient can wear their hair in a high ponytail without fear of exposing obvious scars.

What is it the Ponytail Facelift?

The name, obviously, is a generic-household term, not a medical one. But the ponytail facelift is not a textbook technique that all plastic surgeons learn about in residency. Nor is it new. Davis Cosmetic Plastic Surgery has been using “ponytail” as a descriptor for less-invasive facelifts for decades.

Much like the mommy makeover, there’s no one tried-and-true approach to the ponytail facelift. The nuances of the procedure is dictated by the needs and anatomy of the patient. That said, the overall aesthetic goal is basically the same in every case: elevate the midface and cheeks and, in turn, the partial jawline along the outer jowls for a more elevated look, without any visible scarring.

Keep in mind, plastic surgeons use different names for the various kinds of facelifts all the time, though the intended outcome and the methods used may be similar or almost identical. Also, determining which lift would suit a patient best is a highly-individualized process. 

Generally, however, a ponytail facelift refers to a limited endoscopic lift.

Who is a good candidate?

The procedure tends to be most appropriate for younger patients displaying early signs of aging, such as mild volume loss and fallen cheeks, but not sagging skin and drooping jowls. That’s because the ponytail facelift doesn’t correct a sagging neck and jawline to the same extent than an SMAS or deep-place facelift does.

And endoscopic incisions, while small in size and easily hidden, they don’t allow for skin excision.

The takeaway: Focus more on your goals for the outcome than the name of the procedure. And then once you find your surgeon, trust they’ll use their training and experience to make them a reality. 

If you want to see if this procedure is good for you, please contact the team at DCPS to schedule a consultation.

As we embrace the current reality of the world, it’s almost starting to feel normal to don a mask before entering the grocery store and to have our temperature taken ahead of a haircut. Still, you may be hesitating, understandably, about scheduling your next appointment for filler or neuromodulator. Beyond the natural intimacy of these procedures, there are a number of practical considerations in play—a big one being the handling of the facial assessment that generally precedes such injections.

Every board-certified plastic surgeon across the country reopened their practice this spring with an overabundance of caution. While there was some guidance, the simple fact of the matter is that there was so much about this virus we didn’t know. Virtually every day, we’ve learned something new about it. And with the proper safety procedures we at Davis Cosmetic Plastic Surgery put in place, we’ve come to understand how we can live with it—to a certain extent.

Injectables were one of the last aspects of cosmetic plastic surgery to return. Initially, we scheduled only returning patients because it afforded them some expediency. As everyone grew more comfortable, we made the decision to make appointments available to new patients, too—as long as the patient agreed to a video consult beforehand. By using virtual consultations we are able to minimize our in-person non-procedural interaction.

Where are we now?

Where are we now, nearly six months into the COVID-19 outbreak in the United States? By most estimates, as a plastic surgeon in South Jersey, where infection rates have remained relatively low through the summer, we are back to administering injectables at or near the frequency they were prior to the pandemic. However, that doesn’t mean that it’s business as usual.

We require our patients to wear a mask throughout their treatment, unless it’s necessary for it to be removed. Early on, there was some debate that doing it this way, treating the upper face alone while temporarily ignoring the lower two-thirds could create a lopsided look. And while there’s no doubt that it is a challenge, there’s also value in addressing the face one area at a time.

It’s quite common to stagger treatments and address different areas at different times—the upper face in one visit, the chin and jaw in another, and the midface in a third—to achieve a seamless look in the end.

What can you expect?

Davis Cosmetic Plastic Surgery’s offices have adopted its own protocol to ensure patient and staff safety, but some practices have become universal. We’re finding a way through this by prioritizing safety at every turn to make sure you get your desired treatment, and staying safe.

Please feel free to contact Davis Cosmetic Plastic Surgery with any questions about our safety protocols or to schedule a virtual consult.

You’ve probably read a lot about the seductive lips and chiseled cheeks that fillers can create. But liquid nose jobs and jawline sculpting, two of the most popular requests for injectables, are actually not sanctioned by the FDA. And that’s just the tip of the iceberg.

As plastic surgeons have become more familiar with the nuances of the various fillers, including their different degrees of viscosity, lift, and longevity, they’ve become more inclined to use them in unapproved (or “off-label”) ways. Today, there’s almost no part of the body that hasn’t been enhanced by filler. These are a few of the more intriguing examples I’ve come across.

An alternative butt lift

Interest in the Brazilian butt lift has surged over the last few years. But, in order to achieve the desired results, the patient needs to have enough fat to be liposuction-ed and transferred to their butt. For those who don’t, plastic surgeons have come up with an interesting alternative: injections of Sculptra.

Sculptra induces the growth of collagen, so it’ll add a little more projection to the butt and obscure cellulite dimples in the process. It will take between three to six months to see the enhancement, and it’ll be relatively modest compared to a Brazilian butt lift, but the results will last an estimated four to five years.

Freeing the nipple

For all the attention we devote to breasts, very little is said about nipples. But they’ve become a growing source of insecurity for both men and women. In response, plastic surgeons have begun filling them for all sorts of reasons: one’s an innie and the other’s an outie, or one just sticks out further.

Typically, Restylane Defyne, a hyaluronic-based filler, is used because it’s firm enough to resist the skin’s natural tension. And those more pronounced nipples can last for six to nine months.

Walking on air

Hyaluronic fillers are FDA-approved to add volume to certain aspects of the face, as well as the backs of the hands. But, now, they’re also being used in the balls of the feet to provide additional cushion and alleviate leg and back strain. The trend’s being spurred by healthcare professionals, who can spend more than 12 hours a day on their feet.

Here, injectors turn to thicker, more robust formulations, like Juvéderm Voluma, because they’re able to absorb the constant pressure. Still, because the feet of those seeking the treatment tend to the see a lot of abuse, the filler can wear thin fairly quickly, requiring touch-ups every nine months or so. But what a difference while it lasts, they report.

Needles and fillers are synonymous—for better and for worse. You may dread the former, but your love of the latter’s effects is probably enough to carry you through the treatment.

And yet, a needle isn’t the only way to place facial fillers. In most situations, it may not even be the best way. A 2016 study that compared placing soft-tissue fillers with a needle and a cannula found that the cannula showed “more precision in the placement of product.” When a needle was used, the filler tended to migrate back along the path of the needle, ending up in multiple layers of tissue and skin. The filler placed with a cannula, on the other hand, remained confined to intended location, the deep tissue layers.

The study also indicated that there’s a higher risk of piercing blood vessels when filler is placed with a needle, which can result in bruising and swelling.

I do use a needle to place fillers in certain parts of the face, but, increasingly, Davis Cosmetic Plastic Surgery is turning to the latest-generation cannula, as evidence of its superior comfort and safety mounts.

What is a cannula?

A cannula is also a type of needle, but unlike the kind that’s used by many injectors, the cannula’s tip is blunt. Basically, it looks like a long, thin, flexible tube with a small opening on one side. Its shape and flexibility allows me to inject a variety of locations through a single, small opening, which isn’t possible with a conventional needle.

Fewer injection points, coupled with the reduced risk of piercing blood vessels (and, in turn, less bruising and swelling), equates to less downtime following the procedure.

And that’s not the only significant benefit of the cannula’s unique shape and flexibility. As we age, our skin tends to become undulated across our foreheads and around our mouths and cheeks. It’s the cumulative effect of so many expressions made over and over again. Gradually, the skin becomes tethered to the surface underneath. I can run a cannula under the skin and break up those attachments prior to injecting a filler, further enhancing the filler’s energizing effects.

The future is here

Recently, Restylane Lyft, a hyaluronic acid-based filler, became the first filler of its kind to be approved by the FDA for placement through a cannula in the cheeks and middle of the face. (The FDA has also approved cannula placement of Restylane Silk in the lips.)

In a study that investigated Restylane Lyft’s effects when it was placed in the middle of the face with a cannula, 98.3% of the participants showed aesthetic improvement 16 weeks after treatment, which is quite promising. The takeaway from that is that you could walk away from your next filler treatment with precisely the look you want and much less bruising and swelling to deal with. 

Either way you wish to proceed, we at Davis Cosmetic Plastic Surgery in Cherry Hill is here to make sure we get you the results you want. If you wish to speak to me or one of our team members at DCPS, please contact us and we will setup a virtual consultation.

If the prospect of “going under” is keeping you from committing to the cosmetic plastic surgery you know could make a dramatic difference in your life, consider this: We are performing more and more surgical procedures, like neck lifts and even facelifts, under local anesthesia.

This is a trend Davis Cosmetic Plastic Surgery has practiced for a decade now. Lately, this has gained momentum as plastic surgeons refine their techniques and patients become more enamored with the range of benefits, including that surgery under local anesthesia is less physically taxing, less costly, and, for many, far less intimidating.

Having the option to undergo a growing list of plastic surgery procedures (mini lifts, brow lifts, eyelid lifts, lip lifts, rhinoplasty, breast lifts, and breast implant removals) is making these procedures more accessible to a segment of patients we see who can’t go under general anesthesia, whether because they’re taking a blood thinner or for other medical problems.

But, for most, local anesthesia simply creates a chance to enhance their appearance without worrying about the potential side effects of general anesthesia, including post-operative nausea and vomiting, which is estimated to affect a third of surgical patients. Vomiting after surgery can also lead to increased bruising and swelling, which can lengthen the recovery period.

How Local Anesthesia Works

Local anesthesia affects nerves on a cellular level, shutting down pain receptors so that a patient doesn’t feel anything other than a bit of pressure. A critical difference between local and general anesthesia is that local numbs only the area where it’s injected, while general anesthesia—usually a cocktail of drugs administered through intravenous injection—renders a patient completely unconscious and unable to feel anything.

The most common local anesthesia we use is lidocaine. If you’ve ever had facial filler, you’re probably familiar with its effects because it’s frequently mixed in with the injectable to minimize discomfort at the injection sites.

For more invasive procedures, including surgery, we often use oral sedation, such as Valium, along with local anesthesia. Our goal is to have the patient feel fairly awake, but very relaxed and comfortable. After feeling a few pinches when the local anesthesia is injected, the discomfort is minimal. And then you shouldn’t feel much of anything in that area for a few hours, when the anesthesia finally wears off.

As you consider your plastic surgery options, please know we at Davis Cosmetic Plastic Surgery are here to guide and advise you when it comes to your options and to ensure to receive your desired results.

Please contact us with any questions, or if you wish to have a consultation with Dr. Davis and our staff.