ACNE LASER & LIGHT TREATMENT
Acne is a very common disorder of the skin that affects individuals of all ages. Acne is characterized by comedones (blackheads and whiteheads), red papules and pustules, and sometimes cysts and nodules. These lesions may be painful and often affect the face, jawline, neck, chest, back and shoulders.
In addition to being cosmetically disfiguring, occasionally painful, and associated with emotional distress, acne lesions may lead to permanent scarring making early intervention of paramount importance. While many topical and oral medications can effectively control acne, for more severe cases or patients desiring more rapid or complete resolution, a variety of laser and light sources can be used. In our practice, we utilize blue light therapy and a long-pulse pulsed dye laser. Both devices can be used either alone or in combination with a topical photosensitizer (ALA, photodynamic therapy) to suppress inflammation, destroy the bacteria that is causative in acne and reduce the redness that characterizes active lesions, as well as residual marks left on the skin, known as post-inflammatory erythema.
Once your acne has subsided, depending upon the extent of scarring, you may be a candidate for fractional resurfacing in order to stimulate new collagen and blend in the appearance of acne scars.
Dr. Saini utilize a combination of lasers, injections, peels and topical treatments to help customize each individual patient’s approach to skin aging.
BOTULINUM TOXIN INJECTIONS (BOTOX)
Botulinum toxin injections are among the most popular and sought-after treatments at NY Medical Skin Solutions. The toxin is injected in minute amounts to prevent contraction of the targeted muscle, or to decrease sweating in the affected area, effectively treating both wrinkles and undesirable sweating. Botulinum toxin injections are safe and convenient, and provide natural and reproducible results. Dr. Saini take pride in their ability to keep patients looking natural and not “frozen”. We offer Botox® Cosmetic, Dysport® and Xeomin®.
Chemical peels address a variety of skin concerns, ranging from acne to photoaging (damage to the skin induced by sun exposure, including textural abnormalities, fine lines, and hyperpigmentation). Superficial peels can be divided into beta-hydroxy acids (i.e. salicylic acid) and alpha-hydroxy peels (i.e. glycolic acid). Superficial peels induce controlled injury to the outer layers of the skin, helping to provide a youthful, radiant complexion. Superficial peels are well tolerated with minimal downtime. In certain instances, we offer medium-depth peels, but depending on the individual problem, fractional lasers may offer more predictable and noticeable results.
CLEAR AND BRILLIANT PERMEA®
The Clear + Brilliant® and Clear + Brilliant Permea® lasers target early signs of aging, including abnormal texture, tone and pigmentation. Intended for patients looking for rejuvenated, more radiant skin, these lasers utilize a low-power fractional laser. Multiple treatments are generally recommended, however, improvement in the appearance of one’s skin is evident after a single treatment.
The Clear + Brilliant Permea® procedure is extremely well tolerated with virtually no downtime. Most patients experience warmth and slight tingling during the procedure. Patients often opt to have a topical anesthetic applied for 20-30 minutes prior to the procedure to minimize any discomfort. Immediately after treatment and for up to a few hours after, your skin will be pink. Over the subsequent few days you may notice your skin feels slightly dry although it will not otherwise appear different. Almost instantly, your skin will look more radiant and healthier.
This low level laser also increases the skin permeability, so Dr. Saini may recommend a topical treatment regimen to begin immediately afterwards, to maximize results.
Fillers are among the most popular procedures performed in our office because they offer patients a safe and effective method of rejuvenating the face. Fillers can provide outstanding cosmetic results without the downtime associated with traditional surgical procedures.
These products have become quite popular among younger individuals who prefer to intervene at an earlier stage of wrinkle development, and they continue to be popular alternatives to more invasive surgical procedures in older individuals. Fillers can be used to improve the appearance of fine lines, deeper wrinkles and folds, hollows, volume loss, and acne scarring. Additionally, fillers can be used to enhance the fullness of the lips and for facial contouring. Dr. Saini take a “less is more” approach and always strive to keep the patients looking like a refreshed version of themselves. We prefer to undertreat and have the patient come back to the office for additional treatment or touch-ups as necessary.
Depending on an individual patient’s needs, Dr. Saini may choose a hyaluronic filler to fill in a wrinkle or a hollow, or we may choose one of the fillers that stimulate collagen production to provide more global volume replacement and rejuvenation.
Our list of available fillers and injectables continues to expand to better meet our individual patient’s needs. We offer Restylane®, Perlane®, Juvederm®, Sculptra®, Radiesse®, Belotero Balance® and LaViv, an autologous filler which involves harvesting one’s skin from behind the ear, separating out the collagen-stimulating fibroblasts, and growing them in a laboratory. The patient is subsequently injected with his or her own fibroblasts approximately twelve weeks later to increase collagen production.
Juvederm Voluma® XC
The newest filler we offer is Juvederm Voluma®, a volumizing hyaluronic acid which is used in the mid face to treat volume loss. As we age, we lose volume in our face, leading to the development of hollows, wrinkles and folds. Voluma® is a simple and convenient way to replace lost volume, instantly resulting in a more youthful and rejuvenated appearance.
The use of fillers is safe, effective, and convenient. Most of these fillers can be administered on the day of consultation. Make sure to discontinue any unnecessary blood thinners like Aspirin, NSAIDs, Vitamin E and Fish Oil to minimize bruising. We usually recommend coming into the office at least 30 minutes before your scheduled appointment time so that we can apply a topical anesthetic cream to minimize any discomfort associated with the injections.
Juvederm Volbella® XC, for use in the lips for lip augmentation and for correction of perioral rhytids, commonly referred to as perioral lines, in adults over the age of 21. In clinical trials, Juvederm Volbella® XC was found to effectively increase lip fullness and soften the appearance of lines around the mouth in a majority of subjects through one year.
Juvederm Volbella® XC has been customized with a lower HA concentration (15 mg/mL), while still providing long-lasting results. This makes Juvederm Volbella® XC a soft, smooth gel appropriate for adding subtle volume to the lips and softening the appearance of perioral lines.
Fraxel lasers are characterized by delivery of energy in a fractionated manner. Fractionated refers to energy that is delivered through noncontiguous (interrupted) zones. Accordingly, normal skin is left intact which translates into lesser wounding and more rapid recovery. The Fraxel® Restore Dual laser is a non-ablative fractionated device that stimulates collagen deposition leading to a more rejuvenated, youthful appearance to your skin over several months following treatment. The Fraxel laser has broad applications, including but not limited to photoaged skin (damage induced by UV exposure including wrinkling, abnormal texture, tone and pigment), acne scarring, surgical or traumatic scarring, stretch marks, and for people looking for overall rejuvenation.
LASER HAIR REMOVAL
Excess or unwanted hair is a common cosmetic concern. Sometimes, excess hair can be a result of an underlying endocrine abnormality, a medication or disease. More commonly, it is the result of genetics. Laser hair removal is one of the most commonly performed cosmetic procedures and can be safely and effectively performed on most body parts.
Permanent damage to the hair follicle is achieved when a pigmented hair beneath the skin’s surface absorbs laser energy. For this reason, ideal candidates are those individuals with coarse, darkly pigmented hairs on a background of lighter skin. That said, laser hair removal can be safely achieved with the proper device and proper settings on individuals with all skin types.
On any given day, only a portion (about 20%) of the hairs within a given treatment area will be actively growing and thus susceptible to permanent damage. Therefore, multiple treatments are necessary to achieve the desired effect. The ideal interval between successive treatments is 4-12 weeks (depending on the treatment area).
A thorough understanding of laser-tissue interactions is essential to achieve optimal results safely and efficiently. While this procedure is widely available at Medispas and non-dermatologist offices, at NY Medical Skin Solutions, this procedure, like all procedures, is exclusively performed by our board-certified dermatologist Dr. Ritu Saini.
LEG VEIN TREATMENT
Spider and varicose veins comprise a very common concern. Tiny pink, red or purple vessels known as spider veins of the lower extremities are best treated with sclerotherapy, an essentially painless procedure whereby a sclerosant is injected into the unwanted vessel causing it to collapse so then the body can eventually resorb it. Compression stockings should be worn for between 72 hours to 2 weeks depending on the size and extent of the vessels. Multiple treatments are typically required, but this treatment is very effective. This procedure may sometimes be combined with one of our other vascular lasers to achieve optimal results.
Risk factors for the formation of varicose veins include genetics, female gender, pregnancy, age, occupations that involve prolonged standing, and obesity. These dilated veins are often bluish green or flesh colored, torturous in appearance and palpable beneath the skin ’s surface. Oftentimes, varicose veins are the result of an underlying leaky vessel, a condition known as superficial venous insufficiency (SVI). When valves within a vein cease to function properly, blood is permitted to reflux or flow in the opposite direction than it is intended to flow. Reflux leads to pressure buildup within the vein, causing the vein to distend further. When present, this condition is often associated with symptoms such as aching, burning, fatigue, pruritus, cramps, restless legs and swelling. These symptoms are typically aggravated by warmth and inactivity. If you have varicose veins or symptoms suggestive of underlying venous disease, a noninvasive imaging test (duplex ultrasound) can be performed to delineate the extent of your disease.
If you suffer from SVI, you may be a candidate for sclerotherapy injections performed under ultrasound guidance or endovenous laser ablation (EVLA). EVLA uses thermal energy to close the damaged vein from the inside out. Blood is then re-routed through your healthy veins and overall circulation improves. This procedure, which is generally covered by insurance, is minimally invasive and light exercise can be resumed immediately after.
At NY Medical Skin Solutions, we employ the CoolTouch endovenous laser (CTEV), which is among the latest technology available to achieve the most effective and gentle closure of your varicose veins. CTEV™ results in less bruising and post-operative pain than other available devices. This procedure is over 95% successful and results in near immediate improvement in the appearance of your veins and associated symptoms.
Micro-Needling with Hyaluronic Acid
Micro-Needling with PRP (Platelet Rich Plasma) for Acne Scars and Rejuvenation
Micro-Needling with PRP (Platelet Rich Plasma) for Hairloss
ThermiSmooth Face & Body – Circumferential Reduction, Cellulite Reduction & Skin Tightening
MOHS MICROGRAPHIC SURGERY
Dr. Ritu Saini is a board certified dermatologist, specializing in Mohs micrographic surgery, cosmetic dermatology, dermatologic and laser surgery. Dr. Saini obtained a dermatologic surgery fellowship under the direction of world-renowned Mohs micrographic surgeon, Dr. Perry Robins.
Mohs Micrographic Surgery is a highly specialized surgical technique named after Dr. Frederic Mohs who invented the technique in the 1930s. The procedure is performed in our office under local anesthesia. Mohs is appropriate for certain high-risk tumors, as well as for those tumors that have occurred in cosmetically and/or functionally sensitive areas.
Unlike traditional surgery, Mohs removes skin cancer in successive stages until clear margins have been attained. After local anesthesia is administered, the clinically apparent tumor is removed with a small margin of normal-appearing skin. This tissue is then processed in our on-site laboratory, bisected, stained with multiple colors to preserve orientation, and placed on a slide. Dr. Saini will then examine the slide and determine whether there is any residual tumor at any of the margins. If residual skin cancer is identified, the location of the residual tumor cells is determined and additional stages are removed. This procedure proceeds until clear margins have been attained in every direction. Because of the immediate feedback, the surgeon is able to spare as much normal tissue as possible minimizing the final extent of the defect. Additionally, because of the special way in which the tissue is processed, the procedure is very precise and achieves a cure rate of 98 to 99%.
Depending upon the extent of the defect and its location, Dr. Saini will then discuss with you options for repair, including granulation (whereby the tissue is permitted to heal itself without sutures), a simple linear closure, a skin flap (utilizing adjacent tissue to cover the defect) or graft (borrowing distant tissue to repair the wound). A second visit for suture removal is typically required 1 to 2 weeks later.
Dr. Saini take great care to minimize scarring which results from Mohs surgery.
NON-ABLATIVE LASER RESURFACING
Fraxel lasers are characterized by delivery of energy in a fractionated manner. Fractionated refers to energy that is delivered through noncontiguous (interrupted) zones. Accordingly, normal skin is left intact which translates into lesser wounding and more rapid recovery. The Fraxel® Restore Dual laser is a non-ablative fractionated device that stimulates collagen deposition, leading to a more rejuvenated, youthful appearance over several months following treatment. The Fraxel laser has broad applications, including but not limited to photoaged skin (damage induced by UV exposure including wrinkling, abnormal texture, tone and pigment), acne scarring, surgical or traumatic scarring, stretch marks, and for people looking for overall rejuvenation.
Photodynamic therapy (PDT) utilizes a photosensitizing agent and a light source in order to treat a wide range of skin conditions ranging from inflammatory acne and sebaceous hyperplasia to precancerous lesions (actinic keratoses). A topical photosensitizing agent (i.e. aminolevulinic acid, ALA) is applied to the skin and allowed to incubate for one to several hours. During that time, the ALA is selectively absorbed by precancerous cells as well as by the bacteria that inhabits the skin and can cause acne. A photochemical reaction occurs within these cells that whereby ALA is converted to protoporphyrin IX, a light sensitive agent. When a particular light source is applied to the skin, certain acne and sebaceous lesions, as well as precancerous cells, are selectively destroyed. Strict light avoidance is essential for 36 to 48 hours following treatment. A sunburn-like reaction often occurs and can last for two to ten days, depending upon the intensity of the treatment.
The effectiveness of PDT can be improved by combining the procedure with certain lasers, like the Fraxel laser , Clear + Brilliant Permea® or the V-beam laser, depending on the individual patient’s needs.
PIGMENTED LESION REMOVAL
Pigmented lesions encompass a wide range of skin lesions with different etiologies. Some pigmented lesions may be safely and effectively removed by laser therapy. In general, discrete lesions that are homogenous and stable can be safely eradicated with a single treatment with a Q-switched laser. These lasers deliver energy that is specifically absorbed by the pigment that is more concentrated within the undesired lesion than the background skin. A small scab will form for a few days and then flake off leaving normal skin. For more diffuse pigmentation or confluent pigmented lesions, the Clear + Brilliant Permea® or Fraxel® Restore Dual lasers can be used to blend in imperfections and offer overall rejuvenation.
Any lesion that begins to change or appears distinct from your other lesions (“ugly duckling”) warrants prompt medical evaluation and may require a skin biopsy.
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The minimally invasive way to re-contour your face
• Lasting results
• Immediate results with minimal downtime
Minimally Invasive way to lift facial skin
Cosmetic medical techniques have advanced greatly in recent years. Many aspects of facial aging can be addressed with safe and effective procedures that offer little downtime and natural-looking results. While wrinkles, brown spots and lost volume can be treated with existing procedures, until now there has been no minimally invasive way to lift the deeper layers of facial skin, one of the major contributors to an aged and tired appearance.
Lifting To Redefine Facial Contours
Silhouette InstaLift is a simple procedure to re-contour your face, lifting the deeper layers of your skin for a more youthful appearance.
Dr. Saini will discuss whether this technique is suitable for you and will create a treatment plan to ensure you achieve the results you desire. During the procedure Dr. Saini will use sutures with bidirectional cones to reposition and elevate the skin on your face. The in-office procedure typically takes approximately 45 minutes to complete. You will see immediate results and have minimal recovery time after the procedure.
Over time the sutures will naturally be absorbed by your body while stimulating production of collagen.
SKIN CANCER SCREENING
In preparation for your examination, you should remove all of your make-up as well as any nail polish. Your physician will check you from head-to-toe, utilizing a tool called a dermatoscope when necessary to better visualize your individual lesions. If any suspicious lesions are identified, Dr. Saini will likely perform a skin biopsy whereby the lesion is removed and then submitted to the laboratory to be examined by a dermatopathologist.
Dr. Saini completed her fellowship in Mohs micrographic surgery. In addition to Mohs surgery, she also perform standard excisions of melanoma, dysplastic nevi, and low-risk BCC and SCC, as well as excisions of benign lesions, including cysts, lipomas and benign nevi. Dr. Saini always seek to minimize the formation of scars. She specialize in laser surgery to blend in scars.
Skin tattoos can be decorative or traumatic. No matter the cause, their removal is often desired. Tattoo removal can be challenging and results vary dramatically depending upon the tattoo age, density, color and location. A number of highly specialized lasers exist, each with specific wavelengths to target the different pigments that comprise tattoos. Multiple treatments are the norm. The procedure is performed under injections of local anesthesia. Successful and safe removal can substantially improve one’s quality of life. Dr Saini participates in the American Society of Laser Medicine Surgery New Beginnings program – a national campaign to provide free laser treatments to remove radiation tattoos for cancer patients.
Thermage® CPT uses radiofrequency energy to heat the deeper layers of the skin. This procedure strengthens existing collagen and helps stimulate the formation of new collagen. Thermage® CPT is frequently used to address laxity of the eyelids, jowls, cheeks, neck, abdomen and extremities. Although modest improvement is seen immediately post treatment, the treated area will continue to improve for up to 6 months following treatment. CPT stands for Comfort Pulse Technology™, which enables efficient energy delivery in a more gentle fashion than prior versions of the device. During the procedure, patients experience a sensation of warmth and discomfort. The intensity of the treatment is titrated based upon your particular pain tolerance. When treating certain areas, such as the face, the device incorporates vibration to make the procedure better tolerated.
Following treatment with Thermage® CPT, the treated area may appear pink or slightly swollen, although these effects almost always subside by 24 hours. The majority of patients benefit from a single treatment. Some patients do opt for subsequent treatment in order to achieve additional improvement in laxity. Patients with permanent pacemakers cannot undergo Thermage® CPT or other radiofrequency treatments.
VASCULAR LESION REMOVAL
Vascular lesions can be congenital (from birth or early childhood) or acquired. A variety of laser and light sources exist that are very effective at diminishing or altogether eliminating these lesions, which include hemangiomas, capillary vascular malformations, spider angiomas, broken blood vessels and scars, among others. These procedures are well tolerated and almost always performed without any anesthesia. Post-treatment, swelling or transient darkening of the lesion can occur. However, the dosage of laser energy delivered can be titrated so as to minimize down time.