Facial Skin Care and Non-Invasive Cosmetic Surgery

Soft Tissue Injectable Fillers

As we age, sun exposure, gravity, and ongoing muscle motion can produce significant effects on our appearance. When this is the case, the underlying tissues responsible for a youthful appearance of the skin start to break down, resulting in facial wrinkles, laugh lines and hollows.

The injection of a variety of soft tissue fillers can fill out sunken areas of your face and provide definition to your cheeks and chin. Fillers are also useful if you always wanted fuller, more fashionable, lush lips, or wish that your once larger lips were still that way today.

The subcutaneous fatty tissue below the skin supports the skin against gravity, provides shape, contour, and definition to the skin. Replacement with fillers like micro-fat grafting makes the skin look tighter, more defined and healthier through three dimensional contouring.

The youthful fullness of the mid-face is restored by improving the balance between the amount of facial skin and the underlying supportive tissues. Soft tissue fillers function by plumping up the creased and sunken areas of the lips, cheeks, chin, or forehead. This produces a smoother, more youthful appearance. While there may be some improvement in deep surface wrinkles, there is greater improvement of deeper lines with laser or dermabrasion resurfacing treatment. Soft tissue fillers may be injected as individual procedures or in conjunction with other facial procedures to further enhance the results.

Injectable filler results are variable. Each product has a different location where it is most effective and a different duration of benefit. Some are best for deep wrinkles, some for shallow lines, and others for plumping or restoring youthful volume. Often two or more products may be required to achieve the best results. "We offer a number of non-surgical procedures that allow you to reverse the signs of skin aging without having to commit to plastic surgery," explains Dr Singer. "Our skin care programs and procedures are customized to meet each individual patient's needs." Choosing the best filler for your need and desires requires physician experience and the availability of a variety of choices. Dr. Singer, not an office assistant, will inject your fillers.

At Singer Surgical Centre, we strive to provide the best in technique, technology, and experience for all of your skin care needs. Our La Jolla practice is renowned in California and worldwide for outstanding patient care and quality treatment.

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Injectable Fillers

There are many types of fillers now available to fill in skin lines and creases to restore a youthful appearance. Some fillers can also provide volume and fill in cheek and under eye hollows, enhance cheekbones, lips, and the chin area. These fillers can produce a non-surgical mini facelift:

BOTOX® Cosmetic: Although technically not a filler, this muscle relaxant is best used in the upper face and neck and as an adjunct in the lower face to diminish muscle movement. This temporarily gets rid of muscle movement lines for a younger, smoother look. Read more about BOTOX® here.

Collagen: Collagen is a naturally occurring protein that provides support to various parts of the human body. Collagen injections are used to increase fullness in the lips or to fill in facial lines and wrinkles. Collagen injections act as a temporary replacement for the decrease in natural collagen that occurs as we age. Read more about Collagen here.
- Zyderm® / Zyplast® Injections: You will need a pretreatment test dose to ensure your body will accept the collagen without an allergic reaction.
- Cosmoplast®: A new collagen material that doesn't require a skin test. Read more about Cosmoplast® here.

Hyaluronic Acid Products: Hyaluronic acid is the naturally occurring sugar that is found in the human body, in the skin, cartilage and the eye. In the skin, hyaluronic acid fills the space between collagen and the elastin fibers. It delivers nutrients, hydrates the skin by holding in water, and acts as a cushioning agent.
- Restylane®: Restylane® is clear gel made from a natural, safe, and effective completely biodegradable substance called hyaluronic acid that contains no animal proteins. Restylane® provides natural beauty enhancement and is considered extremely safe. It can be used to add volume and fullness to your skin, reducing wrinkles, and augmenting facial features. Restylane® can be used in conjunction with Radiesse® injections to fill out both the deeper and more superficial lines of the face. The dramatic results are immediate and can last six to nine months. Read more about Restylane® here.
- Perlane®: Perlane® is a denser form of hyaluronic acid, designed for more pronounced wrinkles, facial folds and depressions. Read more about Perlane® here.
- JUVÉDERM™ Injectable Gel: This next generation non-animal hyaluronic acid dermal filler lasts six months or longer.
- Hyalaform® and Captique™: These are other types of Hyaluronic acid products that last 4-9 months. Read more about Hyalaform® here. Read more about Captique™ here.

Sculptra®: Sculptra® is a breakthrough injectable filler composed of poly-L-lactic acid, related to re-absorbable suture material, which is carefully injected beneath the skin to plump the area and gradually thicken facial skin. This is a good filler to restore youthful fullness to the mid- and lower-face. Initially, you may require two to three applications of Sculptra™ to achieve ideal results. It lasts 18 to 24 months. Read more about Sculptra® here.

Radiesse® (Radiance™): Radiesse® is purely synthetic. It is comprised principally of calcium hydroxyapatite, a natural substance that is already found in your body. Radiesse® injections will build up the tissues of the face, reducing deeper folds and creases, and restoring fullness. Radiesse® requires no skin test and the results are instantaneous. It is used off-label cosmetically and lasts 9 to 24 months. Read more about Radiesse® here.

Micro-Fat Grafts: Candidates for fat injections are those with facial contour defects, patients who have lost fat and overall volume, and want to use a filler that is totally natural for them. There is no chance for rejection or allergic reaction, since fat is your own tissue. It is generally felt that 30 percent to 50 percent of the micro-injected fat remains permanently. Read more about Micro-Fat Grafts here.

INJECTABLE FILLER RESULTS DEPEND UPON:

Age
Genetics
Skin quality
Location of the filler
Underlying reason for the loss of tissue or lack of its development
Your general medical condition

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BOTOX® Cosmetic

BOTOX® Cosmetic is a naturally occurring substance that has been formulated to treat the deeper wrinkles in some areas of the face. BOTOX® Cosmetic works by decreasing the activity of muscles that produce these wrinkles including: forehead lines, frown lines between the eyes, and crows feet lines.

When used appropriately, BOTOX® Cosmetic is quite safe. The FDA has approved this non-invasive cosmetic procedure. The effects of BOTOX® Cosmetic are generally thought to last three to four months.

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Restylane® - Hyaluronic Acid Fillers

Restylane® is a cosmetic filler that is used to plump up wrinkles, elevate depressed areas, and enhance the lips. It is made from hyaluronic acid, a substance that exists naturally in our soft tissues. Restylane® is made synthetically in a laboratory from non-animal sources, so there is little or no risk of transmitting diseases or allergies.

Restylane® has been used in other parts of the world since 1996. The results are immediate and generally thought to last six to nine months.

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Skin Resurfacing

Skin resurfacing is a non-invasive cosmetic surgery option for facial rejuvenation. Microabrasion and dermaplaning smooth and exfoliate the top layers of the skin. Further smoothing and refreshing of the skin can be achieved with dermabrasion, which is performed using a special tool. Dermabrasion is effective at reducing facial scars from acne and wrinkles around the mouth. Laser resurfacing is used to smooth facial wrinkles and level raised scars.

All resurfacing techniques have their benefits and limitations, and Dr. Robert Singer will be happy to discuss them with you. Contact our office in La Jolla, San Diego to learn which cosmetic surgery procedure is appropriate for you.

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Facial Peels

Tissue in the deeper layers of our skin break down and thin as we age. This can be caused by heredity, smoking, sun exposure, and the use of harsh drying agents, such as soap or makeup. These signs of aging are typically manifested in the form of wrinkles, lines, spots, stretched pores, growths, and changes in complexion. Thankfully, modern skin care treatments can reduce the visible signs of aging to greatly improve the appearance of a patient’s skin.

The Singer Surgical Centre provides individualized, non-surgical skin care programs which help to dramatically improve the appearance of your skin. Dr. Singer's treatments differ from commercial "skin care," which often consists of only routine applications of over-the-counter products, possibly with no therapeutic value.

Skin Care Treatments Can Revitalize and Rejuvenate Your Skin

Medical skin care helps improve surface discoloration, reduce blemishes, rebuild collagen, and stimulate cell removal. These treatments are beneficial for both women and men.

For patients considering cosmetic procedures, professional skin care treatments can be performed to improve appearance and can accurately determine if cosmetic surgery is necessary to achieve the desired results. If a patient does choose to undergo cosmetic surgery, skin care treatments with Dr. Singer can prepare the skin for surgery, as well as help maintain long-term results after surgery.

Dr. Singer and his entire staff are dedicated to developing personalized skin care treatments. With customized treatments, a patient’s skin will appear healthier and more vibrant. The Singer Surgical Centre utilizes a number of pharmaceutical-grade product lines when developing skin care regimens for patients. These products provide maximum benefit for smoother skin texture. A combination of in-office treatments and at-home therapy products are typically used, including:

BioMedic

Exfoliation, the removal of the top dry layer of skin, occurs naturally every day. The BioMedic pharmaceutical-grade micro-peel is a light lunchtime peel, which accelerates the exfoliation process for exceptional results. Depending on the concentration used, BioMedic can remove superficial layers of damaged skin cells or deeper layers for a more dramatic result.

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Light Fruit Acid (Glycolic or Lactic) Peels

Alphahydroxy acids (glycolic) topical skin rejuvenation assists in the more rapid removal of damaged, dry skin than other treatments. Light fruit acid peels help the deeper layers of the skin retain water in much the same way as younger skin, providing a smoother look with fewer wrinkles and less pigment spotting. This type of peel does not cause excessive irritation and is often used in conjunction with other skin care products. Because the deeper layers of the skin are left intact, the light fruit acid peel offers excellent results with little down time. Such results are not usually achieved with the lower dosage over-the-counter cosmetic products.

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Enzyme Peels

Enzyme peels are special exfoliating treatments that are customized to meet the needs of each patient. These all-natural, non-abrasive, healing treatments infuse gentle sloughing extracts and natural softeners. With enzyme peels, skin becomes noticeably smoother with a refined texture and a more radiant appearance.

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Topical Vitamin A Peels

Topical vitamin A peels revitalize sun-damaged skin and reduce the appearance of wrinkles and other effects of aging. A powerful antioxidant in the peel helps the skin maintain its firm, supple, and elastic properties.

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Salicylic Acid Peels

Salicylic acid peels are mild treatments that are safe for most skin types. Salicyclic acid peels encourage the sloughing of skin cells. Mild acne, oily skin, rough skin, and post inflammatory hyperpigmentation issues can be addressed.

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Pumpkin Peel

Pumpkins contain anti-aging agents, including vitamin A and beta carotene. By speeding up the cell renewal process and exfoliating dead skin cells, the pumpkin peel provides patients with incredibly invigorated skin. The pumpkin peel is also an excellent option for those who are sensitive to the glycolic acid peel.

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Modified TCA Peel

The trichloroacetic acid (TCA) peel treats skin to a medium depth. To provide age-defying results, this peel effectively penetrates the skin, prompting increased cell renewal while helping to rebuild collagen and elastic tissue. Healing occurs in two to three days, typically with only light to moderate flaking. This treatment is more aggressive than the glycolic acid peel.

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Power Peel (Microdermabrasion Treatment)

For a healthier, youthful, and more vibrant look, microdermabrasion removes the outer layer of dry, dead skin cells to reveal the younger skin that lies beneath. Scientific evidence also suggests that microdermabrasion both stimulates the production of new skin cells and improves skin elasticity. For patients with sensitive skin, a series of microdermabrasion treatments can be added to an ongoing skin care regimen in order to achieve optimal results.

Microdermabrasion works differently than topical peels. Using a technique developed in Europe, mini-particles of inert crystals flow gently over the skin at a high rate of speed via a handpiece. Although the skin may be pink after the procedure, the technique involves minimal discomfort with no down time.

Microdermabrasion treatment typically involves a series of four to six treatments at one to two week intervals. To maintain results, additional peels are usually recommended every six to eight weeks after the initial treatment. Microdermabrasion is beneficial for patients interested in:

Softening fine lines and wrinkles (not effective for deeper lines)
Improving dry, thickened areas of skin caused by aging and sun exposure
Decreasing whiteheads and blackheads that result from blocked pores
Reducing blemishes and pigment irregularities

At-Home Skin Care Products

Biomedic (La Roche Posay)
SkinCeuticals®
Solar Protection Tints
Benev®
Liptect
Glo Minerals Makeup
4% hydroquinone
Neocutis
PREVAGE® MD
Retin-A®

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Laser resurfacing and dermabrasion offer other alternatives for the treatment of deeper lines.

Our skin care specialists will use their many years of experience to help you select the appropriate strength and formula of skin rejuvenating treatments. With the many products available, it is important to consult a professional in determining how you can best achieve younger-looking, more vibrant skin. Please contact us today to learn more about how we can help you.

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Micro-Fat Grafting

As we age, sun exposure, gravity, frowning, smiling, chewing, and squinting all have effects on our appearance. The underlying tissues responsible for a youthful appearance of the skin start to break down. As the fatty tissue of the face is re-absorbed, the underlying support of the skin is lost resulting in facial wrinkles, drooping, and hollows.

Injection of a variety of soft tissue fillers, specifically your own fat, can fill out depressed areas of your face, minimize the nasolabial folds next to the mouth, smooth hollows under the eyes and enhance cheek bones , the chin, and jaw lines through three dimensional contouring.

Fat is also useful if you always wanted fuller, more fashionable, lush lips, or wish that your once larger lips were still that way today.

The results of micro-fat grafting are variable depending on age, genetics, skin quality, and location of the injection. The underlying reasons for loss of the tissue or lack of its development, and your general medical condition, also play significant roles in the results.

It is generally felt that patients retain 30 to 50 percent of the injected fat over the long-term. A second or third session of fat injections often results in a longer lasting and improved cosmetic result. Fat injections can be performed alone or in conjunction with other surgical procedures.

Please contact us today to learn more about how we can help you.

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Contact our La Jolla office in San Diego to learn more about our non-invasive cosmetic surgery options.

Robert Singer, M.D., F.A.C.S.
9834 Genesee Ave., Suite 100
La Jolla, CA 92037
Phone: 866.660.0206

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Listed in “Best Doctors in America”
Included in Town & Country, “Best Cosmetic Surgeons in the Country”
Chosen by peers - San Diego Magazine and San Diego County Medical Society, “Best Doctors” and “Best Plastic Surgeons”.
Selected by La Jolla Light Newspaper, “Best Plastic Surgeon”
Past President of The American Society for Aesthetic Plastic Surgery
Past Chairman of the Board of Trustees of the American Society of Plastic Surgeons

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to learn more about Dr. Singer’s honors