Apr 20

First-Time Fillers: A Patient’s Perspective

I was 31 years old when I first had Botox injections. Up until that point, I had really only done peels and facials. I’ve never liked needles, so the thought of them going into my face was not one I was fond of. However, I also was not fond of the creases between my eyebrows, so off to the dermatologist I went. And when I saw the results, I wished I had started sooner.

When deciding where to go, I did my research. The one place I kept hearing wonderful things about was Art of Skin MD – that the facility is state of the art, the providers are the best of the best and the staff is wonderful. It made my decision easy, and I scheduled my consultation. From the moment I made my initial appointment, they lived up to their stellar reputation. And upon arriving to my appointment, everything I’d heard about Art of Skin MD was absolutely true. Another one of the top reasons that I came to Art of Skin MD as a patient is that looking natural is incredibly important to me, and they are known for doing just that. It’s not that I don’t want to age, it is that I want to age gracefully.  I immediately loved that both Dr. Palm and her Registered Nurse, Jessica Scott, approach toxins with that in mind – my face looks fresh, never frozen.

Dr. Melanie Palm and Registered Nurse Jessica Scott
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Mar 1

Restylane Refyne & Defyne – The New Fillers on the Block

           Art of Skin MD is one of the first practices in the San Diego area offering Galderma’s newest members of the Restylane family that are changing the game with a very exciting new ability – flexibility. What makes this so exciting? Flexibility means a more natural look, and in the hands of the right injector, that can be game changing.

            Dr. Palm serves as an advisory board member, clinical investigator, national speaker and physician trainer for Galderma, meaning that she has been selected to educate other physicians on products’ use and safety. She has also assisted in studies related to Galderma products. Both Restylane Refyne and Restylane Defyne were FDA approved in December 2016 and released in the U.S. in January 2017. Prior to this, Dr. Palm was among the first U.S. physicians to inject the product and was selected to learn from Canadian experts outside of the country on injection techniques prior to Restylane Refyne and Defyne becoming available in the U.S.

          What makes these fillers different from other hyaluronic acid fillers already available? The hyaluronic acid strands of both Restylane Refyne and Restylane Defyne are bonded together in a way that creates a smooth gel that may provide not only a longer duration and less swelling than some other fillers used for wrinkle reduction, but also allows for more movement due to its flexibility. One of the most dreaded fears of patients is looking as though they have an unnatural appearance, and this is when choosing the right injector can make a huge difference. Dr. Palm is careful to select the right injectable dermal filler for each patient, and with the smoothness of both Restylane Refyne and Defyne, when injected by expert hands, they lend themselves to a very natural result by integrating into the areas of injection extremely well.


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Jul 27

INFINI Radiofrequency Micro Needling Unveiled First in U.S. at Art of Skin MD

Art of Skin MD proudly announces it is the first U.S. physician office to treat patients with INFINI - a truly innovative radiofrequency device for skin tightening and fine wrinkles.  INFINI received FDA clearance just two weeks ago, and this technology combines the collagen-inducing power of micro needling with a novel multidimensional radiofrequency (RF) platform.  The result is a minimal downtime procedure that produces tissue tightening and wrinkle improvement.   How does the INFINI technology work?  An explanation appears after the following INFINI demonstration videos.  View the videos of treatment (FDA-cleared and off-label use) of acne scarring, skin tightening, and neck wrinkle treatment below from the Dr. Melanie Palm YouTube page:   INFINI radiofrequency micro needling for acne scarring:   INFINI radiofrequency micro needling for the treatment of skin tightening:   INFINI radiofrequency (RF) microneedling for neck laxity and wrinkles:     So how does INFINI work?  INFINI is typically completed as several passes.  The skin is numbed with a topical anesthetic prior to the procedure for patient comfort.  INFINI is composed of two technologies - micro needling and radio frequency....both are explained below:   MICRO NEEDLING: INFINI is composed of a disposable tip with 49 microscopic, sterile tip for each patient treatment.  The needle is only 200 microns, and its tip is only 20 microns.  The needling portion of the INFINI treatment serves several roles: 1) It allows RF energy to be delivered directly into deeper layers of the skin, thereby producing collagen and protecting the top layer of the skin; 2) each entry of the microneedle, on its own, promotes small amounts of collagen production; and 3) the micropores left after treatment allows a conduit for delivering medications directly into the dermis.  This could include growth factors and vitamin A derivatives (retinoids) for collagen production, or serums such as vitamin C, arbutin, kojic acid, or hydroquinone for skin brightening.INFINI RF microneedle san diego INFINI uses a smooth microneedling technique in which one row at a time of the microneedles is delivered over a very short period of time.  This decreases trauma to the skin and improves patient comfort during the procedure.  A schematic of this process is shown below:
Microneedling comfort san diego

Flow needle technology is a patented way of delivering micro needling with radiofrequency INFINI with better patient comfort and less trauma to skin.

                              RADIOFREQUENCY (RF) ENERGY DELIVERY: The second component of the INFINI system is its ability to delivery radiofrequency energy to predetermined depths of the skin, in particular, the dermis.  Unlike other RF devices, INFINI does not treat from the surface of the skin to try and effect the dermis.  With the micro needling technology, INFINI delivers RF heat energy to the second layer of the skin, without going through the top layer of the skin, the epidermis.  This spares the top layer of the skin, which increases patient safety during the procedure, eliminates the risk of burn, and allows the physician to treat ALL skin types.  This is particularly important for darker skin types such as Asian, Hispanic, and African American skin, which can easily experience darkening (hyperpigmentation) after traditional procedures.  Furthermore, the INFINI has a high degree of safety on tanned skin - a skin type that traditionally is difficult to treat with many laser and light technologies.
Radiofrequency wrinkle treatment

INFINI active treatment delivers heat to dermis which encourages collagen growth.

                    INFINI radiofrequency energy is delivered in multiple passes, at multiple depths, allowing for a multidimensional effect that leads to three dimensional volumization of the treated skin.  Typically, 2-3 passes are performed, starting with the deepest layer first.  The adjustable depth is controlled by the physician, and can range from 0.1 to 3.5 mm below the skin's surface.  The length of treatment time during each pulse also determines the zone of collagen heating.  This zone, called a thermocoagulation zone, promotes new collagen growth in the grid of treatment.
INFINI collagen production with radiofrequency heat

Three passes of INFINI creates a three dimensional grid of RF energy and collagen growth.

                A typical treatment session lasts 15-45 minutes depending on whether small areas of the face to complete face and neck zones are treated with INFINI.  Typically, treatment sessions are spaced a month apart and 2-4 sessions are necessary for a meaningful result.   After treatment, therapeutic topical medications and cosmeceuticals may be applied to the skin for enhanced penetration to complement the collagen volumization of INFINI.  Sunscreen is applied.  The skin may be slightly pink for 1-2 days and the skin can feel a little rough to touch for several days.  In general, INFINI is considered a minimal downtime procedure in which someone may return to work or daily activities rapidly without noticeable stigmata of a cosmetic procedure.   INFINI is an excellent complement to other procedures at Art of Skin MD.  Here are various complementary treatments below: 1.  Pretreatment with a botulinum toxin such as Dysport or Botox a few weeks prior to INFINI treatment allows muscle relaxation and an even, smooth, less mobile field of skin treatment.  This discourages wrinkles created by muscle movement to reform and softens them with the collagen producing power of INFINI. 2.  Fine lines around the lips and eyes can be treated first with INFINI and stubborn areas filled with the fine line corrector, hyaluronic acid filler Belotero. 3.  Skin tightening through Ultherapy, which yields results sometimes referred to as a nonsurgical brow lift, face lift, or neck lift, can be used first.  Then, INFINI can be used to produce additional skin tightening to address fine lines and skin crepiness. 4.  Full face "global" revolumizaiton is important to combating the aging face.  This volume replacement should look soft, subtle, natural, and LIKE YOU!  Several agents work well to accomplish this role.  A couple at the top of my list is Sculptra Aesthetic, fat transfer, and Perlane. 5.  Skin rejuvenation with laser technology complements the collagen remodeling effects of INFINI.  To address skin pigmentation, IPL photofacials are often used.  If precancerous skin lesions and heavy sun damage are being addressed.  INFINI may be used following Photodynamic Therapy.  For the ultimate collagen building and skin rejuvenating combination, INFINI can follow CO2 fractionated laser skin resurfacing.   We are proud to be the first clinic to offer treatments with INFINI in the U.S. INFINI, through thousands of treatments, has a proven track record across Asia, the Middle East, Europe, and South America.  Art of Skin MD is delighted to bring this groundbreaking technology to our patients.  For more information on INFINI, contact the qualified Staff of Art of Skin MD at  858.792.7546 or send a message through the Art of Skin MD contact page.      

Jun 18

Men at Work…without Wrinkles using Dysport

Dysport and Botox work well on wrinkles....for men!  As June is Men's Month at Art of Skin  MD, we want to celebrate the favorite guys in your life by giving them the gift of rejuvenation.  This month the special guys in your life can save big on Botox and Dysport with $100 off per area.   Guys can get Dysport and Botox too!  Minimally invasive procedures and injectable procedures like these are increasing among men, and the opportunity for savings through our Men's month special is a perfect opportunity for handsome gents to try out the wrinkle-treating power of neuromodulators.   Dysport and Botox are approached differently in men versus women.  Men have greater muscle strength in the face that requires approaching them differently.  Men should retain their masculine features, and that is why it is important to have an expert injector treating men.   Curious about Dysport in men?  Here is a quick video featuring myself (Dr. Palm) injecting a typical male patient:         Interested in finding out more about the treatment of Dysport or Botox for men?  Call us at 858.792.7546 or contact us through the Art of Skin MD contact page.    

Mar 19

Chest Rejuvenation? Sculptra is Here to Help

Our face isn't the only skin we need to take close and careful care for as we spring into summer.  Most of us are more cognizant about protecting our facial skin, but we neglect to take care of our necks, chest, and hands.


Over time, exposure to sun and environmental elements can cause telltale aging changes to the chest.  UV exposure damages collagen in the second layer of our skin called the dermis.  This loss of support results in skin textural changes and vertical wrinkles in the decollete area.


So what can be done to improve the appearance of this aged skin?  Sculptra!  Completed as a series of treatments, Sculptra injections to the chest promote new collagen growth, strengthening and thickening the soft tissue and skin of the chest area.  This increased support and scaffolding lessens the appearance of skin irregularities and lines in the V-shaped area of the chest.


Watch the YouTube video below to see Dr. Palm demonstrate how Sculptra in placed along the decollete area for chest rejuvenation:



Other procedures can be combined with Sculptra treatment for total chest rejuvenation.  Laser and light procedures can improve the appearance of the skin by eliminating color changes and further improving skin texture.  IPL can eliminate brown spots and broken blood vessels.  Photodynamic therapy (PDT) can treat photodamage and precancerous spots called "actinic keratoses."  The eCO2 fractionated laser skin resurfacing procedure can smooth and tighten skin.  Ultherapy can be used in the chest area to tighten and lift loose skin.


Interested in more information on chest rejuvenation?  Call us at (858) 792-SKIN (7546) or contact us through the Art of Skin MD Contact page.



Mar 13

Dr. Palm Dishes on Dysport and Natural-Looking Results

Dysport (abobotulinum toxin A) is one of the newer "kids on the block" in terms of neuromodulators--a class of medications that relax overactive muscle movement.  Available in other countries for many years, Dysport is a newer addition to American dermatologists seeking to tame stubborn wrinkles on the forehead, between the brows and around the eyes.   Curious what proper injection technique of Dysport looks like?  See how Dr. Palm performs nearly painless injections of Dysport through the short YouTube video below:     The key to natural looking results following Dysport or Botox Cosmetic injections is restraint.  After treatment with Dysport, a person should have relaxed facial expression--not frozen and devoid of all of those facial expressions and characteristics that communicate to others how you feel.   According to FDA-approval, Dysport is approved for up to 4 months of duration.  Additionally, some feel that Dysport may "kick in" a day or so sooner than Botox.  Both products are quite similar and the choice of which product to use is up to the discretion of the patient and physician.   Got questions?  Did we pique your interest in Dysport?  Call us at (858) 792-SKIN (7546) or contact us through the Art of Skin MD website.      

Sep 12

Fractionated Laser Resurfacing (ECO2) –A Fantastic Special for September 2012 to Smooth Skin and Banish Wrinkles

Art of Skin MD and Dr. Melanie Palm are proud to introduce one of the newest laser innovations in laser skin resurfacing, the Lutronic ECO2.  This state-of-the-art device is used to eliminate wrinkles, improve skin texture, remove sun spots, and improve surgical, traumatic and acne scars.


As a special offering to patients, Dr. Melanie Palm is offering an unheard of value for laser resurfacing.  Normally priced at $4500 for the full face, Art of Skin MD is offering to qualified patients laser resurfacing for only $1500 during the month of September 2012.  Patients are encouraged to inquire with the Staff of Art of Skin MD at 858-792-SKIN (7546) to take advantage of this unheard of value.


Fraxel San Diego Art of Skin MD


Fractionated Skin resurfacing and is sometimes referred to as "Fraxel."  This procedure allows for dramatic improvement of facial wrinkles, eyelid droopiness, and vertical lip lines.  Acne scars and surgical scars can be greatly improved with treatment.  For an even more dramatic effect, the ECO2 can be combined with other procedures such as Intense Pulsed Light, Spectra laser treatment, photodynamic therapy, or injectables such as Sculptra for an even more dramatic facial rejuvenation.


Laser skin resurfacing with Lutronic ECO2 can also be used off the face to improve the skin.  The aging neck can be improved following treatment, as can aging hands or the chest or decolletage area.


Results for laser resurfacing continue to improve in the months following treatment.  Fractionated laser resurfacing has greatly decreased the downtime associated with traditional laser resurfacing.  Combining laser resurfacing with wrinkle treatments such as Botox and light fillers can dramatically improve the appearance of the skin.


Contact Art of Skin MD today to schedule your complimentary consultation during this limited time special.