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Dermatology.

Offered by Dr. Kelly Bickle, M.D.

Cosmetic Dermatology

Botox Cosmetic
Botox was FDA approved in April, 2002, for the treatment of glabellar wrinkles (frown lines between the eyebrows). Other FDA approved uses include the treatment of blepharospasm, strabismus, and cervical dystonia.  It has also been used for many off-label indications (treatments that have been widely used, however, are not yet FDA approved), including the cosmetic treatment of lateral periocular rhytides (crow’s feet), brow ptosis (droop), central forehead wrinkles, perioral lipstick lines, and platysmal bands in the neck.   Other off-label uses include the treatment of hyperhidrosis, headache, back pain, and limb spasticity.

Sclerotherapy
Sclerotherapy is the use of injections to treat small varicose veins in the legs. It is traditionally performed with either hypertonic saline or polidocanol. Your physician can help determine which treatment is best for you.

Chemical Peels
Chemical peels are used to treat numerous skin conditions, and can be useful in reducing fine lines and wrinkles as well as improving skin dyspigmentation. The type of chemical peel that is best for you can be determined based on your skin type and the type of damage your skin has. Your physician can help design a peeling regimen that is best for you.

Peels that are offered by Dr. Bickle:

  • Glycolic Acid peels
  • Salicylic Acid peels
  • Trichloracetic Acid peels

Kybella Injections
Kybella is the first FDA approved non-surgical treatment that contours and improves the appearance of submental fullness. It is made up of deoxycholic acid, a naturally occurring molecule in the body that aids in the breakdown and absorption of dietary fat. When injected beneath your chin, Kybella causes the destruction of fat cells. Once destroyed, those cells cannot store or accumulate fat. Most patients experience visible improvement with 2-4 treatments.

Fillers
Fillers are injectable products used to smooth wrinkles or restore facial volume that is lost during the normal aging process. There are numerous types of fillers, and depending on the type of correction or desired result, your physician can help you determine the most appropriate filler for you.

Types of Fillers

Some of the more common FDA approved fillers for the face include the following:

  1. Hyaluronic Acid fillers (HA’s)
  2. Calcium Hydroxylapatite
  3. Poly –L- lactic Acid

Hyaluronic Acid
Hyaluronic Acid (HA) fillers are used to correct deep facial folds, fine lines, sunken cheeks, hollows under your eyes, and thin lips. HA is a naturally occurring substance found in our body’s connective tissues, spinal fluid, and aqueous humor in the eye. HA is hydrophilic and has the ability to draw and hold water. It helps to nourish and moisturize the skin. As we age, we lose not only collagen, but also hyaluronic acid in our skin. When injected into the skin, because HA’s are a natural substance in our body, they integrate smoothly and have very little side effects. The body absorbs the product over time, therefore these are not permanent fillers. The duration of effect depends upon the product used, with a range from 6 months up to 2 years. The most popular HA’s include the Restylane and Juvederm family of products, which are all non-animal stabilized hyaluronic acid (NASHA) fillers. The most common side effects of hyaluronic acid fillers are swelling and bruising at the site of injection.

Calcium Hydroxylapatite
Radiesse is a filler composed of a synthetic calcium hyroxylapatite microsphere and is suspended in an aqueous gel carrier. It is a biocompatible injectable gel for facial soft tissue augmentation. This particular filler is a deep filler used to restore volume to the face, and is frequently used to restore cheek contours. Radiesse can stimulate collagen, and can have lasting effects for up to two years.

Poly-L-Lactic Acid
Sculptra is another filler that is placed deep underneath the skin and used to restore facial volume loss. It was initially indicated for use in HIV facial lipoatrophy, and has since been approved for use in cosmetic rejuvenation of the aging face. Sculptra is an FDA approved biocompatible, biodegradable material that has been used for years in many medical applications, including dissolvable sutures. When injected into the skin, Sculptra stimulates collagen production and is therefore able to provide very natural, long lasting results. However, it may take multiple treatments (usually spaced out between 6-8 weeks) before significant results are seen, therefore, patience is required when using this filler.

Microneedling
Microneedling, also called collagen induction therapy, is a minimally invasive procedure for facial rejuvenation that uses a micro-needling device to create controlled injury to the skin. Each fine needle puncture to the skin creates a micro-wound, stimulating new collagen and elastin production. It causes minimal damage to the skin, with little down time and minimal risk. Multiple treatments (3-6, depending on the individual and the condition being treated) are generally needed.

What is microneedling used for?

  • Reducing scars
  • Fading stretch marks
  • Reducing fine lines and wrinkles

General Dermatology
Skin Exams

Evaluation and Treatment of:
Acne
Eczema
Psoriasis
Rashes
Skin Allergies
Hair & Nail Disorders
Moles
Cysts
Warts
Scars
Pre-cancers and skin cancers